Did I really need twilight sleep and a surgery center to fix my defect? I had a BCC on my nostril. It was three layers deep but in one small part, 4 layers. My Mohs surgeon did not want to do the repair and sent me to a plastic surgeon. He did a graft from behind my ear and put cartilage around the rim. It does sound complex. Did I really need to be knocked out at a surgery center?