WASHINGTON, July 31 - President Reagan has a small skin cancer removed from the tip of his nose by military surgeons today but did not require skin grafts to cover the wound, the White House announced this evening.
.....The President returned to the White House by helicopter after four hours at Bethesda naval Hospital, his nose tipped with bandages. Dressed in a short-sleeve white shirt and brown slacks, he waved to reporters and said, "I feel fine."
.....Marlin Fitzwater, the White House spokesman, said that surgeons took two separate slices of skin from Mr. Reagan's nose. He said microscopic examination indicated that the second slice eliminated all of the cancer cells in the area.
.....He said the procedure "went extremely well" and that Mr. Reagan, who was accompanied by his wife, Nancy, was in good spirits afterward.
.....A statement issues by Col. John Hutton, Jr., of the Army, the White House Physician, said that removal of the cancer took almost two hours and left a wound about 12 millimeters in diameter and 5 millimeters deep.
.....The operation was performed by Capt. Theodore Parlette, chief of dermatology at the hospital. The Navy captain was assisted by Rear Adm. William Narva, the physician to congress, who is also a dermatologist; Dr. Marty Braun, a civilian dermatologist, and Col. Hutton.
....The wound was closed . . . use[ing] some layers of the immediately adjacent skin as a flap to cover the wound, a procedure known as a Linberg (Rhomboid) Flap, and then closed the wound with about 20 stitches in a procedure that took about 45 minutes, the statement said.
.....The Lindberg Flap is less extensive than a full-fledged skin graft using tissue from another part of the body, Mr. Fitzwater said.
.

 Doctors said the area was small and the prognosis
is 'excellent.'

....The President will receive pain medication such as Tylenol as required, and should resume his official duties Monday, the White House said. The stitches are expected to be removed in five to seven days.
....Earlier, Mr. Reagan had minimized the significance of the surgery. "It seems a little overdignified to call what's going to happen surgery," he said at a morning picture-taking session in the Oval Office.
.....The type of cancer found on Mr. Reagan's nose, described by the White House as a basal cell epithelioma, is one of the least threatening and most curable of all cancers. It almost never spreads tumor cells to distant parts of the body.

... When caught and treated early, as in Mr. Reagan's case, it is easily removed. Basal cell cancer is the most common form of skin cancer, afflicting some 400,000 Americans a year.
.....Commenting in advance of the operation, Dr. Perry Robins, president of the Skin Cancer Foundation in New York, said: "The chance of it coming back in the same spot is very small. The prognosis is excellent."
.....The procedure used on Mr. Reagan, Mohs' technique, after the surgeon who invented it, is the most precise form of treatment for skin cancer, with a cure rate that exceeds 99 percent.
.....The technique gains its precision by the use of immediate microscopic examination to make certain that all cancer cells are removed. In curettage, the standard technique for basal cell cancers, surgeons rely heavily on the texture of the tumor compared with surrounding tissue to determine when the tumor is removed. They use sharp curettes, or curved blades, to scoop out the relatively soft, mushy tumor.

.. .This technique was used on Mr. Reagan in 1985, along with electro-dessication, in which the base of the wound is burned with a charge of electricity. The technique achieves a cure in better than 95 percent of all cases, but sometimes a few cancer cells are missed and the tumor grows back.
.....In Mohs' technique, however, surgeons shave off a thin layer of tissue that is believed to contain the whole tumor. The tissue is dyed and frozen immediately and pathologists inspect t under a microscope to determine whether there are any cancer cells. If cancer is found at the edge of the section they have removed, surgeons assume there is more tumor remaining, so they remove another section of tissue. That is examined in turn until all the cancer is excised.
.....The technique allows surgeons to follow the tumor wherever it lies in the body, thus giving a high assurance that all the cancer will be removed. The likelihood that healthy tissue will be cut out unnecessarily is reduced.
.....Mr. Fitzwater said that Mohs' technique, which was not used in removing the two skin cancers found on Mr. Reagan's nose in 1985, was deemed necessary this time because of the location and size of the new tumor, which was larger than the other two.
.....Mr. Reagan was given 3 to 4 cubic centimeters of a local anesthetic, a combination of Xylocaine and epinephrine, injected into the nose with a needle.
.....Recurrent basal cell cancers are extremely common in fair-skinned people who have spent decades in the sunlight, as has Mr. Reagan, who is fond of outdoor recreation and horseback riding.
.....After his 1985 experience with skin cancer, Mr. Reagan was observed applying sunscreen or wearing hats on various occasions in an attempt to protect himself from the sun.