Should I go back to my dermatologist or just see an ENT dr? Is this from pressure of pulling skin too tight or cartilage damage?

Well done for choosing Mohs' surgery, you have a less than 1 % chance of recurrence of the BCC.\If you have not noticed anything for 2 years, your present problem is not because of the surgery you had then. I would go and see an ENT surgeon, who will look into your nose and see why you can't breathe properly. There are many reasons for this.You should compare your nose with pictures from before the surgery, to see whether your nose was tilting to one side or not. What does your family say?The nose undergoes a cycle roughly every 4 hours, which makes one nostril more stuffy than the other, you can have polyps, there might be some other space occupying lesion in there, or you might have developed an allergy.I would see an ENT surgeonBest of luck

Difficulty breathing after nasal reconstruction can occur, but it is usually noticeable immediately after the reconstruction. There are two nasal "valves" near the wing of the nose (nasal ala). If either of these is effected, you can have a sensation of nasal stuffiness. It is hard to say who to see. You could return to the doctor who performed the surgery, but if he/she can't help you, don't hesitate to seek a second opinion. And make sure that someone continues to monitor you to make sure that you don't develop any new or recurrent skin cancers. Good luck.