Moh’s reconstruction is a site specific surgery to reconstruct the area using local flaps and/or grafts. Flaps are plastic surgical techniques where local skin is lifted and rotated into the defect. Grafts are where distant skin is removed and then secured into the defect when a flap closure is not the appropriate choice for certain defects. Special care is taken to minimize the appearance of scars with attention to the natural skin tension lines and careful plastic surgical closure. In either case, the majority of these procedures can be performed in the office under local anesthesia, typically in under an hour.