Concerns with Mohs surgery on the side of nose near the tear duct. What options are available?

I can understand you are nervous about the surgery and the aesthetic and functional result.  But the cancer has to be removed and Mohs surgery has the highest cure rate with the smallest defect.  In terms of reconstruction, ask your surgeon to show you some before and afters of something similar.  Typically Mohs surgeons know which reconstructive surgeons are good at what kinds of reconstruction and yes usually oculoplastic surgeons that do a fair amount of Mohs recon will be good at rebuilding that area. 

The area you are planning on having Mohs surgery is called the medial canthus. Occuloplastic surgeons can do a great job with this area. One major benefit is that if the defect left by Mohs surgery is equidistant both above and below the canthus, the wound can be left to heal by itself and generally heals with beautiful results. If any of the tear draining mechanism is damaged by the Mohs surgery, the occuloplastic surgeon is trained in its repair.Best of luck to you.         jlr