It is common for dermatology surgery patients topresent on the day of surgery with more than one skincancer needing Mohs micrographic surgery. Whenthese carcinomas are located near one another, itmay be more practical to treat both at the same timeas the reconstruction for one defect may involve orotherwise affect the treatment or reconstruction forthe other carcinoma. Treating both cancers on thesame day creates an opportunity for efficient repairswhere a creative single reconstruction may minimizethe amount of tissue wasted during reconstruction,and minimize morbidity for the patient. Further,combining multiple defects into one closure mayreduce cost as it has been shown that reconstructivechoice affects the cost-effectiveness of Mohs surgeryrelative to a traditional excision and Mohs surgeonsmore commonly select less costly options for woundmanagement. We present a case series of two-in-oneclosures - repairing two defects with one closure.