Skin Graft Surgery

Autografts, Allograft, Xenograft
Skin Graft Surgery

Procedure overview

Restoring Function and Aesthetics

Skin grafts are often used when a large wound requires more than just stitches. Sometimes the void or hole can be closed nicely with normal stitches. Other times though, the surgery may leave a wound defect that is so large that stitches alone can’t close it. Such large wounds often cause cosmetic concerns. As a result, they can have detrimental impacts on appearance, self-esteem, function, and quality of life.

Everything that an aesthetic plastic surgeon does aims to restore function while improving the beauty and appeal of your skin. To achieve these goals, it’s sometimes necessary to take healthy skin from one part of the body and use it to cover defects such as a skin surgery wound elsewhere. This is what skin grafting is all about.

Of course, skin graft surgery isn’t simply cutting skin from one area and pasting it onto the wounded area. A lot of expertise and medical knowledge is needed to:

  • Meticulously select a skin graft based on the desired colour, consistency, texture, and robustness
  • Properly harvest skin using techniques that ensure graft success
  • Adequately prepare the skin graft so that it fits its specific destination
  • Fix the graft so that it takes and survives in its new location
  • Encourage healing with minimal recovery time, pain, and a very low risk of complication

Table of Contents

Procedure FAQs

We understand that having surgery can be a big decision, so we have compiled a list of frequently asked questions for each surgical procedure to provide you with more information and help you make an informed decision.

  • What are the different types of skin graft?

    Autografts – Most plastic surgery techniques for skin cancer use autografts. Autografts are skin grafts harvested from one area of the body and used on different parts of the body. The area from which a skin graft is harvested is called the donor site.

    Allograft – Sometimes, a skin graft may be fashioned from cadaver skin that has been frozen and stored. Another person may also donate the skin. Such a skin graft is referred to as an allograft.

    Xenograft – There are also times when plastic surgeons use grafts taken from a pig or any other nonhuman species. Such is a xenograft.

    The human body tends to reject allografts and xenografts within several days. As such, they are used as a temporary wound covering. They must later be replaced with an autograft.

    Synthetic wound dressings and artificial skin grafts are also viable options. They also have their benefits and disadvantages.

  • What factors do surgeons consider when deciding where to harvest skin for a skin graft?

    Your surgeon’s judgment and a preoperative plan created during your consultation meetings will guide the decision on where to harvest skin for grafting.

    Essentially, skin grafts can be harvested from anywhere on the body. However, the skin will only be taken from a donor site that the surgeon feels will have the best functional and aesthetic outcomes.

    Skin can be harvested from a donor site adjacent to the defect. Such a graft, known as Burrow’s graft, is sometimes preferred because it offers the best match in terms of both colour and texture.

    A major principle in skin graft is trying to achieve similarity between the donor and defective skin characteristics. A dermatologic surgeon will always try to attain a match in the expected aesthetic appearance—’ like skin is best repaired with like skin.’

    There are other instances when the skin graft has to be acquired from donor areas distant from the defect. Grafts may, for example, be taken from the thighs, clavicular skin, nasolabial fold, palm, sole, abdomen, groin, buttocks, back, scalp, etc.

    Before deciding on the best donor site, your surgeon will consider:

    • Postoperative comfort
    • Postoperative mobility
    • Risk of infection
    • Graft preparation requirements
    • Postoperative care needed
    • The tendency of the donor site to form large scars

    It’s only logical that skin is harvested from a site with minimal interference with the patient’s recovery and rehabilitation after skin cancer surgery.

  • What surgical tool is used for harvesting skin for grafting?

    The main surgical tool for harvesting skin is the dermatome. Dermatomes are special knives/razors that cut out thin skin slices from the donor site.

    Many types of dermatomes, electric, air-powered, and manual, can be used. And in as much as the surgeon’s skill is essential when harvesting skin, the technique and apparatus (dermatome) used could mean the difference between successful grafting and suboptimal outcomes.

    Dr Sorensen, therefore, ensures that his team works with the best cutting-edge equipment.

    Local anaesthesia may be applied at the donor site when collecting small skin grafts. Large skin grafts will, however, be collected under general anaesthesia. After the skin has been harvested, the donor site will be dressed to protect it from infections and trauma.

  • What are the different types of skin for skin grafts?

    The skin consists of two main layers: an outer epidermis and an inner layer, the dermis.

    The epidermis is a tough outer protective layer that consists of a superficial layer of dead cells and several underlying layers of rapidly dividing cells.

    The dermis mainly consists of connective tissue. It also has blood vessels, sweat glands, oil glands(sebaceous glands), hair follicles, nerves, and lymphatics.

    Depending on how much of the epidermis and dermis a graft contains, it is considered either a partial-thickness graft or a full-thickness graft.

  • What is a split thickness graft (STSGs)?

    Split thickness grafts (STSGs), or partial thickness grafts, include the epidermis and a small portion of the underlying dermis.

    • An STSG is usually harvested using a dermatome
    • The skin mustn’t be harvested too deep at the donor site. This is because the grafted tissue needs to be nourished by the dermis of the recipient site for a split-thickness graft to be successful
    • The donor site from which an STSG is taken usually heals within a few days
    • Once transferred to the new recipient wound bed, a few small sutures may be used to hold the graft in place
    • A sterile, non-adherent dressing will then be used to cover this area for a few days

  • What are full-thickness grafts (FTSGs)?

    Full-Thickness Skin Grafts (FTSGs) include the dermis and epidermis. They also come with hair follicles, sweat glands, and other adnexal structures.

    Although more complicated than STSGs, FTSGs will have better outcomes with respect to natural colour, texture, and contour.

    • Surgeons often use scalpels (rather than dermatomes) to harvest full-thickness grafts
    • After cutting around, the FTSG is usually lifted off with a special hood
    • Fatty tissue is then trimmed off from the graft (defatting)
    • The donor site needs to be closed—often done using an absorbable suture
    • The graft is transferred onto the wound and secured in place with the appropriate fixation technique (see below)

    FTSGs are generally used for small wounds. Common areas where FTSGs are used include the hands, face, and scalp.
    Reconstruction with FTSGs usually results in good cosmetic outcomes and durable skin cover.

  • What is a composite skin graft?

    Some large defects require 3-D skin reconstruction using a graft that includes skin tissues, fat, and/or cartilage. Such as graft is known as a composite skin graft.

    For instance, a composite graft containing skin and cartilage may be used to repair the nose.

  • What techniques are used to expand grafted skin to compensate for the shrinkage of skin grafts?

    A skin graft begins to shrink as soon as it’s harvested—probably due to the recoil of dermal elastic fibres. After being transferred to the recipient wound bed, the graft will again continue shrining as it heals. This is particularly true for STSGs.

    The surgeon needs to compensate for the shrinkage by either harvesting a considerably larger graft or using various techniques to expand grafted skin.

    Skin graft expansion may be achieved by:

    • Breaking up the donor skin into tiny pieces that will be placed onto the recipient bed (pinch graft)
    • Cutting the donor skin into strips (relay transplantation)
    • Cutting the donor skin into strips, then sheet grafts, and finally stretching it into a mesh (meshed grafts)

    Most of these skin expansion techniques are used when the surgeon needs to cover large areas. As such, they are more frequently used in treating large skin burns and not so much for small skin cancers.

  • How do you ensure the graft takes and survives?

    Fixing the graft onto the defect ensures the graft doesn’t separate from the wound. This helps the graft to take and survive.

    Take is a term used to describe a skin graft’s reattachment and revascularization (development of a blood supply).

    Once the graft has been transferred onto the recipient site, the surgeon may use various novel methods to ensure that the graft takes and remains fixed onto its new site.

    Generally, a skin graft adheres to a new site in 2 phases.

    The first phase lasts for about 72 hours after grafting. A thin fibrin layer holds the graft in place during this phase.

    The second phase follows the first phase. During the second phase, fibrous, and vascular connective tissue growth occurs between grafted and recipient skin. The new fibrovascular connections are responsible for keeping the graft in place after the initial 72 hours.

    Dr Sorensen will aid graft adherence and survival in various ways, including:

    • Immobilizing the area around the skin graft
    • Securing the skin graft to the wound using staples, foams, sutures, graft dressings, or other adhesive agents
    • Using a sub-atmospheric pressure device to assist in wound closure (VAC therapy)
    • Effective dressing and wound coverage
    • Ensuring sterility and cleanliness of the area around the graft

    You can help your graft take by avoiding activities that:

    • Are likely to cause bleeding
    • Expose the wound to dirt, water, moisture, and other fluids
    • Result in shearing forces that pull the graft away from its bed

    Be also on the lookout for infections and report to your doctor as soon as you suspect your wound is infected.

  • What is the timeline for the healing and recovery process of a skin graft?

    The graft swells during the first 48 hours as it gets engorged with plasmatic fluid.

    Within 2-4 days, capillaries start to grow into the graft from its under surface.

    Normal blood flow (revascularization) may be restored into the skin graft within 5-7 days.

    The dermis may swell remarkably during the first week, but the swelling goes down as blood, and lymphatic vessels grow into the graft.

    The healing process generally begins on day 7-8 after the grafting.

    STSGs often need to be lubricated within the first three months because they lack sebaceous (oil) glands.

    Normal skin sensation over the graft may return as early as 1-2 months post-surgery but may be abnormal for the first year.

  • What are the potential risks and complications of skin grafting?

    Every surgical procedure is associated with certain risks and potential complications. However, it is important to know that many of these complications can be avoided or can disappear over time with no additional treatment. To learn more about this, read our risks and complications of plastic surgery page.

  • How much does skin grafting cost?

    The cost of grafting varies from patient to patient. Each grafting case is usually unique hence the rates charged will be different. Different surgeons also charge differently. There are many Medicare Item Numbers for Skin Grafting and Skin Cancer Surgery to claim your Medicare Rebate. You may also get a subsidy from your Health Insurance Fund. For more information, please contact us today.

Anything we've missed?

If you have any further questions or concerns that we haven’t addressed in our FAQ section, please don’t hesitate to contact us – our team is always here to provide the information and support you need throughout your journey.

Risks

The information provided on this website is for general informational purposes only and should not be considered medical advice.

Surgical procedures carry inherent risks, and the specific risks and potential complications may vary depending on the procedure. It is important to consult with a qualified and experienced surgeon to discuss the risks, benefits, and potential outcomes of any surgical procedure. Individual results may vary.

For more detailed and specific information regarding the risks associated with a particular procedure, please contact our clinic directly to schedule a consultation with our skilled team of healthcare professionals.

Surgical Costs

Navigating Surgical Costs: Consultations, Insurance, and Financial Options

At FNQ Plastic Surgery, we work with you to navigate the cost of your desired procedure, taking into account the various factors that influence pricing, and offering flexible payment options to accommodate your needs.

Medical Consultations for Non-Cosmetic Procedures (skin cancers, hand surgery etc.)

  • Initial consultation: $280
  • Follow-ups: $85

Cosmetic Consultations (in person or virtual)

  • Initial consultation: $350
  • Follow-ups: $100

Children Consultations under 18 years

  • Initial consultation: $250
  • Follow-ups: $85

Terms

All prices include GST. You will be required to make a deposit of $100 to secure your booking. Your appointment will be confirmed and secured once paid. We accept Visa, Mastercard and American Express via electronic banking details over the phone.

Skin cancer

Payment for skin cancer/ skin lesion surgery is due (7) days prior to your surgery booking date.

Cosmetic surgery

To secure an appointment for cosmetic surgery, you are required to make a deposit as outlined below. The final payment is due to FNQ Plastic Surgery 2 weeks prior to your scheduled date. Please reference your surname and contact us once payment is complete.

Surgeon feeDeposit required

Up to $10,000$1,000
$10,000 – $20,000$2,000
$20,000 +$3,000

Payment options

  • Direct Deposit
  • Bank cheque made payable to FNQ Plastic Surgery (we do not accept personal cheques)
  • Major credit cards accepted – including AMEX
  • Cash

Refund policy

If you cancel or reschedule your procedure less than (7) days prior to your surgery date, you will be responsible to pay thirty percent (30%) of the total costs of the procedure (non-refundable and cannot be applied to a future procedure).

Average prices paid for cosmetic and plastic surgery are different across Australia. Prices and Hospital Costs vary for plastic surgery as every patient has slightly different anatomy and varying surgical needs. Your Price for surgery depends mostly on which surgeon, which hospital, the type of prosthesis and how long the surgery will take. It will also vary based on eligibility for Medicare and whether you are insured or uninsured.

A fully personalised quote for your plastic surgery procedure is available when you come for a confidential consultation.

Your quote as part of a fully informed financial consent will outline your specific:

  • Surgeon Fee
  • Hospital Costs based on theatre time and length of hospital stay
  • Anaesthetists Fee
  • Assistants Fee (if applicable)
  • Prosthesis, Implant fee and post-operative garment fee (if applicable)
  • Any Medicare codes that may be applicable to your surgery

Many patients want to know if Medicare will cover plastic surgery. Medicare will cover what is deemed essential reconstructive surgery and procedures that have associated Medicare item numbers listed in the Medicare Benefits Schedule (MBS).

Dr Sorensen and his team can help you understand if Medicare may cover your procedure. However, if you wish to look up a particular type of surgery and its item numbers, refer to the Medicare Benefits Schedule.

Medicare will not cover cosmetic surgery procedures – like a cosmetic breast augmentation.

If you meet the strict criteria, you may be eligible for a Medicare item number Breast Surgery, Tummy Surgery, and post weight loss Excess Skin removal, amongst many other procedures.

You can undertake your surgery as a self-funded (uninsured) patient, or you may be covered by your Private Health Fund. There are many private health funds, some more generous than others.

Your Private Health Fund may partly contribute to the cost of your surgery. If you have a valid medical referral and meet the specific criteria for a Medicare Item Number.

You must also have the right LEVEL of insurance cover – Gold, Silver or Bronze – for the type of surgery you want. You may have to delay surgery after initially joining a health fund – typically, a 12-month waiting period needs to be served before you can have surgery.
If you have private health insurance, it is your responsibility to check your level of cover for this procedure. If you are not covered for the procedure, you will be responsible for hospital fees. Below are listed questions you should ask your health fund:

  • Am I covered for the Cairns Private Hospital or Cairns Day Surgery?
  • Am I covered for the item number(s) listed on my quote?
  • Will I be covered if this surgery is combined with a cosmetic procedure that does not have an item number?
  • Do I have an excess to pay when I go to hospital? if so, how much is it?

Nearly all plastic surgeons now charge a GAP fee on top of what Medicare and Private Health Funds are willing to contribute for your surgery. Medicare rebates have been fixed and have not increased for years. This has resulted in few, if any, NO GAP Plastic surgeons willing to charge the standard Medicare fee and health fund rebate.

You may be able to get early access to your Superannuation Fund to pay for your life-changing surgery.

This will most likely apply to Abdominoplasty (Tummy Tuck), Breast Reduction, Body Contouring, Arm lift, Nose Surgery or Skin Reduction after significant weight loss or Bariatric Surgery.

The Australian Tax Office (ATO) will assess your Early Super Fund Access application for medical procedures that treat life-threatening illnesses or chronic pain. The final decision, however, will be made by your own Super Fund, as some funds will not allow withdrawal. Find out more by visiting the ATO website or contacting Supercare.

Financing for cosmetic & plastic surgery

Flexible Financing Solutions for Your Procedure

At FNQ Plastic Surgery, we’re dedicated to making your desired procedure more accessible. That’s why we’re proud to partner with leading Australian financial service Total Lifestyle Credit (TLC) to offer flexible financing solutions tailored to your needs.

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TLC provides personal loans designed for financing medical and lifestyle expenses. With competitive interest rates, flexible repayment terms, and a simple application process, TLC can help you easily finance your procedure. Visit TLC’s website for more information.

DISCLAIMER – Our Practice is NOT a credit provider. We do NOT receive any rebates or commissions from ANY banks or credit suppliers. All finance and credit providers are independent external companies. We provide NO financial advice. You will need to consider your own financial circumstances when deciding if finance is suitable for you.

At the heart of our practice is a deep commitment to patient care, ensuring each individual receives the utmost attention, safety, and satisfaction.

We strive to provide the best care possible for our patients. That’s why we offer a comprehensive range of resources on our Patient Care page, including information on patient registration, consultation and treatment, disclaimer information, and other vital resources. Please click the button below to access our Patient Care page and learn how we can assist you throughout your journey.

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