what-is-a-skin-graft

You’ve probably heard of skin grafts used as treatment for serious burns. However, did you realize that they skin grafts may be needed after skin cancer treatment or reconstructive surgery? There are several instances in which a skin graft is an appropriate and effective treatment.

What is a skin graft?

A skin graft is a surgical procedure in which sections of healthy skin (the “donor site”) replace damaged tissue. Donor skin may come from the lower neck or behind the ear. It’s crafted to fit the shape of the defect and sewn in place. This is an effective method to repair damaged or missing skin, but the graft does not have its own blood flow. New blood vessels must grow before circulation can be restored.  

What is the difference between a skin graft and a flap?

A skin flap is very similar, except during a flap, fat and muscles are also transplanted. Then, the healthy skin is surgically connected to a blood vessel, ensuring that the flap has its own blood flow. This technique accelerates healing and minimizes scarring. 

When do you need a skin graft (or flap)? 

Serious, large wounds will need help from a skin graft or flap to heal. Other instances include:

  • Extensive skin loss from an infection
  • Diabetic ulcers that don’t heal
  • After an amputation
  • After a mastectomy
  • After Mohs surgery to remove skin cancer 

What is Mohs surgery?

Mohs is a type of surgery used to remove of skin cancers. During the procedure, the tumor is removed along with a thin layer of skin. Then, the surgeon examines the skin cells under a microscope. If cancer cells are still there, another layer of skin is removed. The process repeats until there’s no sign of cancer cells.

Mohs surgery offers several advantages: it minimizes scarring, spares healthy issue and produces better outcomes. 
Afterward, reconstructive facial surgery is needed, particularly if several layers of skin were removed. A flap or skin graft is ideal for correcting these  defects. Our nationally recognized facial plastic surgeons at Raleigh Capitol Ear, Nose and Throat are uniquely equipped to help patients after Mohs surgery. 

What are some common skin graft/ flap procedures?

We provide procedures such as:

Bi-lobe flap

After Mohs surgery, it’s not unusual for a patient to have a defect or hole in his or her face after the cancer has been removed. A bi-lobe flap can repair this by rearranging nasal skin to fit the area. Because nasal skin is used, it perfectly matches the texture and color of the area to be repaired. You can view some before and after surgical pictures on our website

Nasolabial flaps 

Nasolabial flaps are a good option for repairing nostril and nasal tip defects. During two outpatient procedures, skin from the cheek (the “donor site”) is transplanted to the nose. The cheek has a similar texture and color to nasal skin. 

Forehead flaps

Forehead flaps are used when grafting is not an option. This complex operation is very effective when repairing an intricate and detailed structure like the nose

Raleigh Capitol Ear Nose and Throat physicians specialize in skin grafts, flaps and facial reconstructive surgery

We’re very fortunate to have two nationally recognized, board-certified surgeons with extensive expertise who help our patients. 

Dr. David Clark 

Dr. Clark performs facial reconstruction surgery, specializing in helping patients who have undergone Mohs surgery. He has performed thousands of procedures and completed a fellowship with the nationally renowned plastic surgeon, Dr. Richard Farrior. Dr. Clark is board-certified by the following organizations: the American Board of Otolaryngology, the American College of Surgeons, and the American Board of Facial Plastic and Reconstructive Surgery. He serves patients in our West Raleigh and Garner locations.

Dr.  Kevin Doyle 

Dr. Doyle has extensive expertise in reconstructive surgery, nasal and sinus surgery, and pediatric otolaryngology. He’s board-certified by the American Board of Otolaryngology and is a fellow of both the American College of Surgeons and the American Academy of Otolaryngic Allergy. He’s a member of the American Academy of Facial Plastic and Reconstructive Surgery. He serves patients at our Midtown Raleigh, Cary and Brier Creek locations.

Is a flap or skin graft the right choice for you?

A skin graft or flap can be a viable option for many facial reconstructive surgeries, particularly if you’ve had skin cancer removed. If you are scheduled for Mohs surgery and have questions about facial reconstruction, please contact us. We’ll be glad to answer any questions you have. 


Raleigh Capitol Ear, Nose, and Throat is the area's premiere physician-owned ENT practice with six convenient locations throughout Wake County. Our board-certified physicians have extensive experience in treating both common and complex cases to help adults and children alike. We offer six local ENT offices throughout Raleigh, Cary, Garner and Wake Forest.  For more information or to schedule an appointment, contact us


Sources:

American Cancer Society. “Surgery for Basal and Squamous Cell Skin Cancers.” Online. 

U.S. National Library of Medicine. National Institutes of Health. “Skin Grafts and Flaps: Self-care.” Online. 

U.S. National Library of Medicine. National Institutes of Health. “Expanded Uses of the Nasolabial Flap.” Online.

U.S. National Library of Medicine. National Institutes of Health. “The Forehead Flap: The Gold Standard of 
Nasal Soft Tissue Reconstruction
.” Online.