Basal cell carcinoma (BCC) is a nonmelanocytic skin cancer that arises from basal cells, slow-growingtumors that almost never metastasize. Untreated BCCs have the potential to continue to grow anddestroy surrounding skin and nearby structures leading to physical deformity. The key to treatmentis to ensure that there is no more cancer left in the skin. Reconstruction with V-Y skin flaps can beperformed in several areas of the face. We reported a 62-year-old female patient with pigmentednodular BCC tumor on left cheek who was successfully treated with wide excision with V-Y skin flapunder bilevel surgical tumescent anesthesia.