Forehead Donor Site Full-Thickness Skin Graft

Abstract

BACKGROUND. Full-thickness skin grafts (FTSGs) are useful for reconstructing nasal defects. Traditional reported donor sites include the preauricular, postauricular, supraclavicular, clavicular, conchal bowl, melolabial fold, and upper eyelid skin. Selection of the ''best'' donor site is based on the ''best'' tissue match and ability to camouflage the donor scar. OBJECTIVE. The purpose was to report our experience with FTSGs harvested from the forehead for reconstruction of nasal defects following Mohs' surgery. METHODS. A retrospective query of the Mohs' surgery database was performed to identify nasal defects repaired with a FTSG harvested from the forehead skin. The research record contained

The Placement of Structural Cartilage Grafts Under Full-Thickness Skin Grafts: A Case Series and Strategies for Successful Outcomes

“…(Figure 2D–F) This focal sloughing was most commonly seen on the portion overlying the cartilage graft, as might be anticipated. Similar to the reported cosmetic outcomes for simple FTSGs, 7–10 three cases developed mild graft hyperpigmentation (Figure 1G), and one developed subtle hypopigmentation.…”

The Placement of Structural Cartilage Grafts Under Full-Thickness Skin Grafts: A Case Series and Strategies for Successful Outcomes

“…(Figure 2D–F) This focal sloughing was most commonly seen on the portion overlying the cartilage graft, as might be anticipated. Similar to the reported cosmetic outcomes for simple FTSGs, 7–10 three cases developed mild graft hyperpigmentation (Figure 1G), and one developed subtle hypopigmentation.…”

Cheek Donor Site for Full-Thickness Skin Graft Repair of the Nasal Ala: Outcomes of a Retrospective Cohort Study

“…7 The glabella has superior tissue match but creates a prominent cosmetic penalty and harbor the possibility of creating a synophrys. 10,11 The preauricular and postauricular areas often heal with significant color and textural mismatch compared with the native nasal skin. Grafts from the supraclavicular region limit arm range of motion, extend healing time to 1 to 2 weeks, and still heal with less color and texture match compared with the facial skin.…”

Forehead Reconstruction with Microvascular Flaps: Utility of Aesthetic Subunits

“…[1][2][3][4][5][6][7][8] When full-thickness forehead defects present, however, grafts flatten normal contour, resulting in a noticeable deformity perceivable even from far distances. 10,24,[26][27][28][29] Finding the optimal donor site in terms of tissue quality, color, texture, thickness, and size is often challenging, and particularly so when dealing with full-thickness forehead wounds, which can require variable amounts of tissue bulk. 10,29 Given the aforementioned factors, when presented with full-thickness wounds-especially those involving underlying calvariumthe forehead split-thickness skin grafts, although proven for superficial forehead resurfacing, are not our first choice.…”

“…Tissue expansion is additionally associated with inadequate coverage for full-thickness bony defects, with poor results in irradiated tissue and with a high complication rate evidenced by extrusion, paresthesias, infection, and contracture. 1,29,32 All of these factors must be considered influential to making a careful choice regarding reconstructive approach.…”

“…Skin grafts in such cases flatten normal contour and result in deformity that is perceivable even at great distances. 10,29 Due to the lack of underlying tissue and/or bone, such wounds alter the natural contours of the forehead and warrant microvascular reconstruction. Utility of a tailored microvascular flap to fit the subunit avoids this aesthetic inadequacy.…”

The Placement of Structural Cartilage Grafts Under Full-Thickness Skin Grafts: A Case Series and Strategies for Successful Outcomes

“…(Figure 2D–F) This focal sloughing was most commonly seen on the portion overlying the cartilage graft, as might be anticipated. Similar to the reported cosmetic outcomes for simple FTSGs, 7–10 three cases developed mild graft hyperpigmentation (Figure 1G), and one developed subtle hypopigmentation.…”

Cheek Donor Site for Full-Thickness Skin Graft Repair of the Nasal Ala: Outcomes of a Retrospective Cohort Study

“…7 The glabella has superior tissue match but creates a prominent cosmetic penalty and harbor the possibility of creating a synophrys. 10,11 The preauricular and postauricular areas often heal with significant color and textural mismatch compared with the native nasal skin. Grafts from the supraclavicular region limit arm range of motion, extend healing time to 1 to 2 weeks, and still heal with less color and texture match compared with the facial skin.…”

Forehead Reconstruction with Microvascular Flaps: Utility of Aesthetic Subunits

“…[1][2][3][4][5][6][7][8] When full-thickness forehead defects present, however, grafts flatten normal contour, resulting in a noticeable deformity perceivable even from far distances. 10,24,[26][27][28][29] Finding the optimal donor site in terms of tissue quality, color, texture, thickness, and size is often challenging, and particularly so when dealing with full-thickness forehead wounds, which can require variable amounts of tissue bulk. 10,29 Given the aforementioned factors, when presented with full-thickness wounds-especially those involving underlying calvariumthe forehead split-thickness skin grafts, although proven for superficial forehead resurfacing, are not our first choice.…”

“…Tissue expansion is additionally associated with inadequate coverage for full-thickness bony defects, with poor results in irradiated tissue and with a high complication rate evidenced by extrusion, paresthesias, infection, and contracture. 1,29,32 All of these factors must be considered influential to making a careful choice regarding reconstructive approach.…”

“…Skin grafts in such cases flatten normal contour and result in deformity that is perceivable even at great distances. 10,29 Due to the lack of underlying tissue and/or bone, such wounds alter the natural contours of the forehead and warrant microvascular reconstruction. Utility of a tailored microvascular flap to fit the subunit avoids this aesthetic inadequacy.…”

The Placement of Structural Cartilage Grafts Under Full-Thickness Skin Grafts: A Case Series and Strategies for Successful Outcomes

“…(Figure 2D–F) This focal sloughing was most commonly seen on the portion overlying the cartilage graft, as might be anticipated. Similar to the reported cosmetic outcomes for simple FTSGs, 7–10 three cases developed mild graft hyperpigmentation (Figure 1G), and one developed subtle hypopigmentation.…”

Cheek Donor Site for Full-Thickness Skin Graft Repair of the Nasal Ala: Outcomes of a Retrospective Cohort Study

“…7 The glabella has superior tissue match but creates a prominent cosmetic penalty and harbor the possibility of creating a synophrys. 10,11 The preauricular and postauricular areas often heal with significant color and textural mismatch compared with the native nasal skin. Grafts from the supraclavicular region limit arm range of motion, extend healing time to 1 to 2 weeks, and still heal with less color and texture match compared with the facial skin.…”

Forehead Reconstruction with Microvascular Flaps: Utility of Aesthetic Subunits

“…[1][2][3][4][5][6][7][8] When full-thickness forehead defects present, however, grafts flatten normal contour, resulting in a noticeable deformity perceivable even from far distances. 10,24,[26][27][28][29] Finding the optimal donor site in terms of tissue quality, color, texture, thickness, and size is often challenging, and particularly so when dealing with full-thickness forehead wounds, which can require variable amounts of tissue bulk. 10,29 Given the aforementioned factors, when presented with full-thickness wounds-especially those involving underlying calvariumthe forehead split-thickness skin grafts, although proven for superficial forehead resurfacing, are not our first choice.…”

“…Tissue expansion is additionally associated with inadequate coverage for full-thickness bony defects, with poor results in irradiated tissue and with a high complication rate evidenced by extrusion, paresthesias, infection, and contracture. 1,29,32 All of these factors must be considered influential to making a careful choice regarding reconstructive approach.…”

“…Skin grafts in such cases flatten normal contour and result in deformity that is perceivable even at great distances. 10,29 Due to the lack of underlying tissue and/or bone, such wounds alter the natural contours of the forehead and warrant microvascular reconstruction. Utility of a tailored microvascular flap to fit the subunit avoids this aesthetic inadequacy.…”