I was dx'd with a small basal cell on my nose. I am 36 & don't have other medical problems . My MD said the Mohs is unnecessary, i.e. it's too small and if he referred me for Mohs they might laugh at us. I don't want to have a deforming scar in a prominent place. How small is too small for Mohs? He recommends we do a punch excision . My derm is HMO and I am concerned they are trying to save $ rather than provide the best removal method.