Basal cell carcinoma (BCC) is the most common type of skin cancer and frequently appears in the centre of the face, particularly the nose. Long-term exposure to ultraviolet radiation is a risk factor for BCC. Biopsy findings routinely confirm the clinical diagnosis. Complete surgical resection is most commonly used in the treatment of facial skin cancer, and the methods used for defect closure are primary closure, local flaps and skin grafts. This article reports a 73-year-old man who complained of a blackish spot on the side of the nose and infra-orbitalis dextra that occurred about two years ago. The complaint was accompanied by itching and bleeding when scratched. The patient was diagnosed with basal cell carcinoma from the history, physical examination, dermoscopy examination, and histopathology. The surgery is carried out in two stages: first, Modified MOHS surgery and secondly, defect closure is performed using the Paramedian Forehead Flap, Rotation Flap and Skin Graft. On the 28th day of follow-up, the surgical wound had dried up completely. The combination surgical technique of paramedian forehead flap, rotation flap, and skin graft can be a treatment option in large facial basal cell carcinoma to achieve an excellent cosmetic and functional outcome.