What does a skin graft do?
It covers an area of missing skin using skin taken from another part of your body.
The transferred skin must establish a blood supply from the wound underneath.
Craniofacial & Facial Reconstruction
Facial Skin Graft Reconstruction
Facial skin graft reconstruction moves healthy skin from another body area to cover a facial wound where skin is missing.
Is it the same as a facial flap?
No. A graft is transferred without its own blood supply.
A flap brings tissue with a blood supply and may be more suitable for deeper wounds or exposed structures.
Will the skin match?
Your surgeon aims for a suitable match, but differences can remain.
Color, texture, thickness, and contour may differ from the surrounding facial skin.
01 · Overview
Replacing missing facial skin
Facial skin graft reconstruction may be considered after skin cancer removal, injury, a burn, or removal of damaged scar tissue. It replaces missing skin rather than lifting the face or simply smoothing an existing scar. [1]
Your surgeon prepares the wound, takes skin from a donor site, and secures it over the defect. The wound needs a suitable blood supply for the graft to survive. A protective dressing may help keep the graft in contact with the tissue beneath it. [1]
A graft creates two healing areas: the facial site and the donor site. Your surgeon considers both when choosing the skin and explaining likely scars, color differences, and follow-up care. [1]
- Purpose
- Cover a facial skin defect
- Treated sites
- Facial wound and skin donor site
- Anesthesia
- Local anesthesia, sedation, or general anesthesia
- Healing
- Early graft healing followed by months of scar changes
Why might a graft not be the best choice?
Some wounds lack enough healthy, well-supplied tissue to support a graft. Exposed structures, infection, prior radiation, or a need for added tissue thickness can change the plan. A flap or staged reconstruction may be more appropriate.
How is this different from scar revision?
Scar revision aims to improve an existing scar or release tight scar tissue. A graft replaces missing skin. The two can overlap when releasing or removing a scar leaves a wound that cannot be closed directly.
02 · Concerns & Goals
What reconstruction can address
A facial wound can affect both appearance and daily comfort. The plan depends on its location, depth, and the healthy tissue beneath it.
An open facial wound
A graft may provide coverage when the edges cannot be brought together safely without excessive tension or distortion.
Skin loss after treatment or injury
The size and depth of missing skin help determine whether grafting can provide suitable coverage.
Tight or restrictive scars
Releasing tight scar tissue may leave a gap that needs replacement skin. Tightening can still recur during healing.
Changes near facial features
Wounds close to the eyelid, nostril, or lip need careful planning because healing and shrinkage can affect their position or function.
03 · Options
How the approaches differ
The choice depends on the wound's blood supply, depth, size, and location. These approaches are not interchangeable, and suitability requires a surgeon's assessment.
Full-thickness skin graft
Transfers the outer skin layer and the full underlying dermis.
How it worksThe surgeon removes a piece of skin and usually closes the donor site with stitches.
May suitSelected smaller facial defects where skin thickness and limiting later shrinkage are important.
Main tradeoffThe donor site must be closable, and the graft needs a well-supplied wound bed. A visible patch or contour difference can remain.
Split-thickness skin graft
Transfers the outer skin layer and part of the dermis.
How it worksA thin layer is harvested, leaving a donor wound that heals from skin structures remaining underneath.
May suitSelected larger or more superficial wounds that need broader coverage.
Main tradeoffTexture differences and later contraction may be more noticeable, which matters near mobile facial features.
Unmeshed sheet graft
Places the graft as a continuous sheet rather than an expanded mesh.
How it worksThe skin is fitted to the facial defect and secured to reduce movement and fluid collection.
May suitVisible areas where avoiding a mesh pattern is a priority, if the wound allows.
Main tradeoffCareful contact with the wound is essential; blood or fluid trapped underneath can interfere with healing.
Staged graft reconstruction
Prepares or reassesses the wound before placing the graft.
How it worksWound treatment or additional tissue assessment comes first, followed by grafting when conditions are suitable.
May suitSelected wounds needing further preparation or confirmation that tumor removal is complete.
Main tradeoffThis can mean a longer treatment course, additional dressings, or more than one procedure.
Thickness, sheet placement, and timing describe different parts of a graft plan; your surgeon may combine them. A graft cannot reliably survive on every wound surface. [1].
Where will the donor skin come from?
The surgeon considers color, thickness, texture, hair growth, available skin, and the donor scar. Depending on the graft needed, possible sites include skin near the ear, the neck, or another body area.
Can a graft restore missing facial volume?
A skin graft mainly provides surface coverage. It does not replace substantial missing fat, muscle, or bone. A deeper defect may need another form of reconstruction.
04 · Results
What may improve and what may remain
Coverage and protection
A healed graft can provide lasting skin coverage.
- Success depends on blood supply, close contact with the wound, and avoiding infection or movement.
- Partial or complete graft loss may require further wound care or reconstruction.
Appearance over time
The graft's early appearance is not its final appearance.
- Color, swelling, and firmness can change over months.
- Differences in pigment, texture, thickness, or contour may remain.
Comfort and facial movement
Coverage or scar release may help comfort, but healing can also cause tightness.
- Grafts can shrink as they heal, potentially pulling on nearby features.
- Later scar treatment or revision may be discussed after healing is assessed.
Skin grafting leaves scars at both treatment sites. Neither grafting nor scar revision can promise an invisible scar or an exact match. [2]
05 · Recovery
Planning your recovery
Recovery at a glance
- Stay after surgery
- Determined by Your Surgeon
- Initial recovery at home
- Varies by Individual
- Return to desk work
- Varies by Procedure and Work Activity
- Light daily activities
- Based on Individual Recovery
- Strenuous exercise
- Based on Surgeon Clearance
Returning to work does not mean fully healed. Follow your surgeon’s instructions; strenuous activity requires clearance.
Your team will give separate care instructions for the facial graft and donor site. Timing varies with graft size, location, wound health, and any other reconstruction performed.
Step 1 · Day of surgery
Treatment day
The graft is secured and covered. A pressure dressing, sometimes called a bolster, may hold it in place. Your team explains pain control, dressing protection, and whether you need help at home.
Step 2 · First several days
Early graft protection
The graft is establishing its blood supply. Avoid disturbing its dressing and follow your team's restrictions on facial movement and physical activity. The donor site may also be sore.
Step 3 · First few weeks
Healing checks
Follow-up visits assess graft survival and donor-site healing. The team decides when to remove dressings or stitches and when washing or other skin care can change.
Step 4 · Following months
Scar settling
Color, sensitivity, and firmness continue to change. Your surgeon may discuss sun protection and scar care once the skin is ready. Returning to work does not mean healing is complete.
Planning everyday activities
ActivityGeneral planning contextWhat affects the plan
Work and social plansPlanning context: Timing depends on dressings, discomfort, and job demands. [1]What affects it: Physical work, bending, dust exposure, or pressure on the face may require a longer break than desk work.
Exercise and liftingPlanning context: Resume according to your surgical team's clearance. [1]What affects it: Strain, rubbing, and movement can disrupt early healing or contribute to bleeding.
Washing and skin productsPlanning context: The graft and donor site may have different rules.What affects it: Ask when each area can get wet and when makeup, shaving, or skin products can safely resume.
Glasses, masks, and sleep positionPlanning context: Discuss anything that touches or presses on the graft.What affects it: Your team may suggest ways to avoid pressure or friction based on the graft's location.
Follow your surgical team's instructions rather than a general recovery schedule. Ask your surgical team whether compresses are appropriate and exactly how to use them.
Before your procedure
- Discuss the wound's cause and any ongoing cancer treatment or pathology results.
- Review all medicines, supplements, and allergies; change medicines only with the prescribing clinician's guidance.
- Tell the team about smoking, vaping, and nicotine use so they can plan support for healing.
- Review conditions that affect healing, including diabetes, circulation problems, and prior radiation.
- Arrange transportation and home support based on the planned anesthesia and dressing needs.
- Confirm follow-up visits, donor-site care, and whom to call about problems after hours.
Can I judge graft survival by its color?
Not reliably. Early grafts can look different from surrounding skin, and dressings may hide the area. Let your team assess healing. Report a new or rapidly changing appearance rather than removing the dressing to check.
Will the graft feel normal?
Numbness or altered sensation is common early on. Sensation may improve gradually, but it may not fully match the surrounding skin. Protect the area from injury while feeling is reduced.
06 · Safety
Risks and what your clinician assesses
Some soreness, swelling, bruising, and altered sensation can occur at the facial and donor sites. The donor site may be uncomfortable even when the facial graft is not. Symptoms should follow the pattern your team describes, not steadily worsen.
Partial or complete graft loss
Poor blood supply, movement, pressure, or fluid beneath the graft can prevent it from healing. Additional treatment may be needed.
Bleeding or fluid collection
Blood or fluid can collect beneath the graft and separate it from the wound bed.
Infection or delayed healing
Either treatment site can become infected or take longer to close, sometimes requiring medicines or another procedure.
Visible scars and skin mismatch
Raised scars, pigment changes, uneven texture, or a depressed or raised contour may remain at the graft or donor site.
Contraction and altered function
Healing skin can tighten, potentially affecting an eyelid, nostril, or lip. Persistent tightness or sensory changes may need assessment.
Anesthesia or medication complications
Reactions and other complications depend on the anesthesia used, your health, and the extent of surgery.
Discuss these risks and your individual health history with your surgeon. [1]
What your clinician assesses
- Wound size, depth, blood supply, and exposed structures
- Proximity to the eyelid, nose, lip, and other functional features
- Donor-site options, skin characteristics, and scarring history
- Medical conditions, nicotine use, medicines, and prior treatments affecting healing
07 · Costs
What makes up the Total Procedure & Care Cost
Compare written estimates for the same planned scope: facial wound preparation, graft type and size, donor-site care, anesthesia, and follow-up. A staged reconstruction may involve separate charges.
Surgeon
Surgical care
Surgeon services for wound preparation, graft placement, and donor-site treatment.
Ask your surgeonAsk whether additional stages, pathology, or later revisions are included or billed separately.
Facility
Anesthesia and facility
The treatment setting, anesthesia services, and recovery-area care when needed.
Ask your surgeonConfirm who bills for each service and whether the proposed setting is covered by your insurance.
Supplies
Supplies and follow-up
Dressings, prescribed medicines, and postoperative visits as specified in the estimate.
Ask your surgeonAsk about home supplies, extra visits, and care if healing takes longer than expected.
TRC
Patient Services
Any separately listed coordination or administrative services.
Ask TRCAsk whether there is a charge, what it includes, and whether it is optional.
Your written estimate should explain the services included, any separate charges, and payment terms.
08 · Questions
Common questions
Is facial skin graft reconstruction covered by insurance?
Coverage may be available for medically necessary reconstruction, but benefits and authorization requirements vary. Ask about the graft, wound treatment, facility, and any later revision separately.
Can grafting happen immediately after skin cancer removal?
Sometimes. Timing depends on the wound and how the treating team confirms that the cancer has been adequately removed. Some situations call for delayed reconstruction.
Will hair grow on the graft?
Hair growth depends on the donor skin and the graft's thickness. Your surgeon considers hair-bearing skin when choosing a donor site for a visible facial area.
What if the graft does not heal completely?
The team assesses how much skin has survived and whether infection, fluid, or poor blood supply contributed. Options may include wound care, another graft, or a different reconstruction.
0 consultation questions in your plan
View in My TRC workspaceMy Aesthetic Plan
Prepare for your consultation
Bring these to help your consultation:
- Understand the graft plan, donor site, alternatives, and likely limitations.
- Arrange personalized aftercare, support, and follow-up for both healing sites.
- Review the written estimate, insurance requirements, and after-hours contact plan.
View My Aesthetic Plan
Choices stay in this visit until saving to your account completes. Nothing is sent to a clinician.
Sources
- [1]MedlinePlus — Skin graftSkin graft purpose, split- and full-thickness grafts, donor sites, anesthesia, preparation, dressings, healing, activity protection, and complications including graft loss, infection, bleeding, and sensory changes.
- [2]American Society of Plastic Surgeons — Scar RevisionLimits of scar improvement, scar contracture treatment, and the use of surgical closure, skin grafts, or tissue flaps in selected scar reconstruction.
Photographs are illustrative scenes, not patients, staff, facilities or outcomes. This information does not replace a personal assessment by your treating clinician.