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Heat a No.8 (10 ¼”) or No.6 (8 ⅜”) cast iron skillet over medium heat. Spread some butter on the insides of the bun and toast, buttered side down, until golden brown. Set aside and spread with mayonnaise, if using.
Add the sausage patty or bacon to the skillet and cook to desired doneness (or crispiness). Add to the bun, leaving any leftover fat in the pan, and immediately top with one slice of American cheese.
In a bowl, beat the eggs with a pinch each of salt and pepper. If there’s not much fat left in your skillet, add a small knob of butter and melt. Pour the eggs into the skillet and stir quickly with a silicone spatula to form an even layer of eggs. Once the bottom has set, which will take about a minute, sprinkle the cheddar cheese (if using) into the center of the eggs, then use the spatula to fold the sides into to form a square about the size of your bun. Transfer the egg to the bun and immediately lay the remaining slice of American cheese on top. Turn off the heat.
Top with sliced avocado and dash some hot sauce on top (if using) and close the sandwich. Wrap the sandwich tightly in aluminum foil and return to the skillet, letting it warm for about 1 minute on each side. Unwrap and enjoy.