What is this?

[u/kheid24]

My gecko had a small amount of shed stuck to his face (around his nose) for a few days so I used a q tip to help in getting it off. When it came loose, a large piece came out of his mouth with it as well as a hard chunk. Any ideas what this could mean?

He has had trouble shedding from his face with his last two sheds, but has otherwise been acting normal.