High-viscosity 2-octyl cyanoacrylate (HVOCA) is a tissue adhesive that forms a strong bond across apposed wound edges, allowing normal healing to occur below. It is used to replace sutures in laceration or incisional repair. We report a case of an 88-year-old woman who underwent Mohs micrographic surgery for removal of a biopsy-proven nodular basal cell carcinoma on the right side of the nose. Two stages of Mohs surgery were required to achieve a cancer-free margin, and the surgical defect was corrected with a rotational flap and application of HVOCA on the superior surgical edge. In this case report, the cheek rotational flap along with HVOCA application on the nonsutured borders of the Mohs defect was successfully used for facial reconstruction. This combined approach in reconstructing the Mohs defect by scar positioning at the nasolabial fold level along with HVOCA application on the superior border of the surgical wound was a suitable treatment option for this patient.