What does this procedure treat?
Scar tissue that has tightened and shortened the skin.
The goal is often to reduce pulling or improve movement, rather than simply make a scar less visible.
Scar, Skin & Wound
Scar Contracture Release with Skin Graft
Scar contracture release with a skin graft loosens tight scar tissue and covers the opened area with skin taken from another site.
Why is a skin graft needed?
Releasing a contracture may leave an area that cannot close without tension.
A graft provides skin coverage, but it needs a healthy wound bed and protection while it attaches.
Will the scar disappear?
No. Both the treated area and the skin-donation site can leave scars.
Texture, color, sensation, and movement may improve unevenly, and tightness can return.
01 · Overview
Making room for easier movement
A scar contracture develops when healing tissue pulls the skin tight. It can follow a burn, injury, or surgery and may restrict movement, especially near a joint. [1]
During release, the surgeon cuts through or removes restricting scar tissue. A skin graft covers the resulting opening using skin from a separate donor site. Unlike a flap, a graft does not bring its own blood supply and must establish circulation from the tissue beneath it. [2]
This is different from resurfacing or treating a raised scar alone. The plan must address both skin coverage and function. If deeper tissues also limit movement, skin release alone may not fully correct the problem. [1]
- Main purpose
- Release tight scar tissue and restore skin coverage
- Skin source
- Usually your own skin from another body area
- Anesthesia
- Depends on the location and extent of surgery
- Recovery focus
- Protect the graft, then restore movement as directed
Why does the tissue beneath the graft matter?
A graft needs a wound bed with enough blood flow to support healing. Infection, poor circulation, or exposed structures without suitable covering may make a flap or another approach more appropriate.
Can an older contracture still be treated?
Sometimes. Scar age is only one consideration. Your surgeon also checks joint movement, skin quality, deeper tissue changes, and whether therapy or a different reconstruction is needed.
02 · Concerns & Goals
What brings people to a consultation
A tight scar can affect how you move, feel, or use part of your body. Your surgeon can assess what is causing the restriction.
Restricted movement
Tight skin may limit bending, straightening, or reaching, particularly across a joint.
Pulling or discomfort
A scar may feel stretched or uncomfortable during everyday tasks. Not all scar pain improves with release.
Skin breakdown
Repeated rubbing or tension can make fragile scarred skin crack or develop wounds that need assessment.
Visible scarring
You may notice a tight band, uneven contour, or color difference. Grafting changes coverage but does not restore unscarred skin.
03 · Options
How the approaches differ
The graft choice depends on the size, location, wound bed, and risk of renewed tightening. These approaches may be combined within a treatment plan.
Full-thickness skin graft
Uses the full thickness of the skin.
How it worksSkin is taken from a donor area that is usually closed with stitches.
May suitSelected smaller defects where limiting later graft contraction is important.
Main tradeoffDonor skin availability is limited, and the graft needs a well-supplied wound bed.
Split-thickness skin graft
Uses the outer skin layer and part of the deeper layer.
How it worksA thin layer is harvested from a donor site, which heals under dressings.
May suitLarger released areas that need broader skin coverage.
Main tradeoffIt can contract more during healing and may differ visibly in color or texture.
Sheet graft coverage
Places a graft without a mesh pattern.
How it worksThe surgeon fits a continuous piece of skin over the released area.
May suitSelected sites where surface appearance matters and enough donor skin is available.
Main tradeoffIt covers less area than an expanded graft, and fluid beneath it can interfere with attachment.
Meshed graft coverage
Uses small openings in a split-thickness graft.
How it worksThe openings allow drainage and can let the graft expand over a larger area.
May suitSome larger defects or situations with limited donor skin.
Main tradeoffA mesh pattern may remain visible, and contraction remains a concern.
Graft thickness and sheet versus mesh placement are separate choices. Your surgeon should explain why the proposed combination fits your wound and movement goals. [1] [2].
Why might a flap be recommended instead?
A flap moves tissue with its own blood supply. It may provide better coverage when a graft would not survive reliably or when deeper structures need protection.
Does release always require a graft?
No. Some contractures can be treated by rearranging nearby skin, such as with Z-plasty. A graft is used when additional skin coverage is needed and the wound bed can support it.
04 · Results
What may improve and what may remain
Movement and function
Release may improve usable movement, but the amount varies.
- Long-standing stiffness in joints, tendons, or other tissues can limit improvement.
- Therapy and prescribed splinting may be important to maintaining the release.
Appearance and sensation
The graft becomes part of the repaired area, but may not match nearby skin.
- Color, texture, thickness, and contour can differ.
- Numbness or altered sensitivity may persist, and the donor site also leaves a mark.
Long-term durability
Healing continues beyond initial graft attachment.
- Scars can change over months, and grafted skin can tighten again.
- Further therapy or surgery may be needed for recurrent restriction or incomplete healing.
Scar revision can improve function or appearance, but it cannot erase a scar or guarantee a particular result. [1]
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.
Recovery involves two sites: the graft and the donor area. Protection and movement must be balanced according to the location and your surgeon's plan.
Step 1 · Day of surgery
Treatment day
The graft is secured and covered with a protective dressing, sometimes with a bolster or negative-pressure dressing. You receive a site-specific plan for movement, pain control, and follow-up.
Step 2 · First days
Early graft protection
The team checks that the graft is attaching and that fluid or infection is not interfering. Dressings and any splint should be managed only as directed.
Step 3 · Following weeks
Wound healing and guided movement
The donor site and graft heal at different rates. Your team decides when washing, movement exercises, therapy, and scar care can begin.
Step 4 · Following months
Scar maturation
Follow-up focuses on skin quality, movement, and any returning tightness. A long-term therapy or splinting plan may be adjusted as healing progresses.
Planning everyday activities
ActivityGeneral planning contextWhat affects the plan
Work or schoolPlanning context: Timing depends on the graft location, wound care, and daily demands. [2]What affects it: Desk duties may be possible before physical work; returning does not mean complete healing.
Exercise and stretchingPlanning context: Movement near the graft may initially be restricted. [2]What affects it: Too much movement can disrupt attachment; too little later can contribute to stiffness. Follow the prescribed progression.
Bathing and swimmingPlanning context: Dressing type and wound closure determine what is safe. [2]What affects it: Ask when each site may get wet and when soaking or swimming is allowed.
DrivingPlanning context: You need safe control of the vehicle without medication-related impairment.What affects it: Pain, splints, restricted movement, and the graft location can delay return.
Use your surgical team's instructions rather than a fixed calendar. Do not start stretching or change dressings without knowing the plan for your graft.
Before your procedure
- Discuss which movements or tasks are most limited and what improvement would matter to you.
- Review prior scar treatments, wounds, infections, and surgeries.
- Share all medicines, supplements, allergies, and nicotine use.
- Ask for individualized instructions about medication changes, fasting, and nicotine cessation.
- Arrange transportation and help with tasks that could strain the graft or donor site.
- Confirm dressing supplies, therapy arrangements, follow-up visits, and whom to call after hours.
Which site may hurt more?
Either site can be uncomfortable. A split-thickness donor site can feel like a raw scrape, while the release site may feel sore or tight. Ask how pain will be managed and which changes need a call.
Will I need a splint?
Possibly, particularly near a joint. The team should explain its purpose, wearing schedule, skin checks, and when guided movement begins. Do not improvise a splinting or stretching routine.
06 · Safety
Risks and what your clinician assesses
Soreness, swelling, bruising, and altered sensation can occur. The graft may initially look different from surrounding skin, and the donor area may remain sensitive while it heals.
Partial or complete graft loss
The graft may not establish enough circulation. Further wound care or another operation may be needed.
Infection or delayed healing
Either site can become infected or heal slowly, especially when circulation or general health is impaired.
Bleeding or fluid collection
Blood or fluid beneath the graft can separate it from the wound bed and affect survival.
Recurrent tightness
The graft and surrounding scars can contract, limiting movement again or requiring further treatment.
Lasting skin or sensation changes
Raised scars, color differences, contour changes, persistent pain, or numbness can affect either site.
Anesthesia and general surgical complications
Medication reactions and blood clots are possible. Individual risk depends on your health and the extent of surgery.
Discuss these risks and your individual health history with your surgeon. [2]
What your clinician assesses
- Scar location, size, skin quality, and movement before and after release
- Wound-bed circulation, infection, and any exposed deeper structures
- Diabetes, nicotine use, medications, and other healing or anesthesia risks
- Available donor sites and ability to follow wound care, therapy, and splinting
07 · Costs
What makes up the Total Procedure & Care Cost
Compare written estimates for the same planned scope, including the release area, graft type, donor-site care, and anticipated follow-up or therapy.
Surgeon
Surgical care
Assessment, contracture release, graft placement, and donor-site closure or dressing.
Ask your surgeonAsk which surgeon visits and any additional procedures are included.
Facility
Anesthesia and facility
Anesthesia services and the operating facility.
Ask your surgeonAsk whether these are billed separately and whether an overnight stay is anticipated.
Supplies
Supplies and follow-up
Dressings, splints, wound checks, and possible rehabilitation.
Ask your surgeonAsk about separate charges for therapy, home wound care, and specialized dressings.
TRC
Patient Services
Any care-coordination or administrative services listed in your estimate.
Ask TRCAsk which services are optional, who provides them, and whether they carry separate fees.
Your written estimate should explain the services included, any separate charges, and payment terms.
08 · Questions
Common questions
Is this the same as removing a scar?
No. The key purpose is releasing restrictive tissue and replacing missing skin coverage. Some scar may be removed, but the procedure creates new healing edges and a donor-site scar.
Where will the donor skin come from?
That depends on the graft thickness, amount of skin needed, and available healthy skin. Your surgeon should discuss the donor scar, healing needs, and likely color or texture match.
Can tightness come back?
Yes. Grafts and scars can contract during healing. Follow-up, prescribed therapy, and sometimes splinting help manage this risk, but cannot eliminate it.
Will insurance cover the procedure?
Coverage depends on your plan and the documented functional or reconstructive need. Ask about authorization, network status, therapy benefits, and your share of charges before scheduling.
0 consultation questions in your plan
View in My TRC workspaceMy Aesthetic Plan
Prepare for your consultation
Bring these to help your consultation:
- Confirm the release area, graft method, donor site, and realistic goals.
- Get a written wound-care, movement, therapy, and follow-up plan.
- Review warning signs, contact numbers, and the itemized estimate.
View My Aesthetic Plan
Choices stay in this visit until saving to your account completes. Nothing is sent to a clinician.
Sources
- [1]American Society of Plastic Surgeons — Scar RevisionScar contractures and movement restriction; scar revision goals and limitations; grafts, flaps, and tissue rearrangement as reconstructive approaches.
- [2]Cleveland Clinic — Skin GraftSkin graft types, donor sites, wound-bed blood supply, sheet and mesh graft considerations, recovery protection, graft failure, infection, bleeding, sensation changes, and postoperative warning signs.
Photographs are illustrative scenes, not patients, staff, facilities or outcomes. This information does not replace a personal assessment by your treating clinician.