Skin Graft Fell off 2 Weeks After Mohs Surgery

2 weeks ago I had mohs..on graft fell off to day -appears to be healing with big cavity this correct or do I need to contact MD sooner that apt next week?

Doctor Answers 12

Skin cancer removal and skin grafts - Los Angeles

Always a good idea to discuss your situation with the surgeon who treated you. You may find that underneath the scab, there is fully epithelialized and vibrant skin.  Skin grafts can sometimes result in concavities, but these often fill in to some degree. Raffy Karamanoukian, Los Angeles

Los Angeles Plastic Surgeon
4.8 out of 5 stars 94 reviews

Loss of Graft

As surgeons, we've all had skin grafts fail.  If its never happened to a surgeon, it just means they haven't done many. 

That being said, I think we would all want to know if one of our grafts fails.  Sometimes the wound will still heal perfectly well and its not a big deal. Other times the wound is going to benefit from some kind of intervention. 

Personally, I really want my Mohs patients to have a good result and I want to have the opportunity to intervene if its not healing according to plan. 

Arlo J. Miller, MD, PhD
Issaquah Dermatologic Surgeon

Skin Graft Fell Off

A good rule of thumb is if it's not healing as expected go back and see the doctor that performed the surgery. A graft falling off is not expected so go back and let the doctor examine the area to determine what if anything needs to be done.

Andrew Kaufman, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 16 reviews

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Grafts can be tricky

The best advice is to call your surgeon.  Sometimes grafts may look poor - but actually still be viable.  Other times they can fail or even fall off.  Either way, your doctor will be able to help you determine what happened and the best course of action at this time.

Jeffrey Ellis, MD
Long Island Dermatologic Surgeon
5.0 out of 5 stars 1 review

Skin Graft After Mohs Surgery

There is no real way to ascertain what has happened to the skin graft without an examination, and this should be done by your Surgeon sooner rather than later.  Skin grafts heal in phases, because they autogenous material without a blood supply.  Skin grafts (both full and split thickness) take weeks and usually months to look cosmetically acceptable.  For this reason, I very rarely use a skin graft on the nose unless there is a very specific reason to do so.  The initial and long term healing from a local flap (bilobe) yields a better color and texture match in the near and long term than the vast majority of skin grafts.  The biggest concern is the color of the graft, which very rarely matches the tone of nasal skin.

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon
4.8 out of 5 stars 93 reviews

Skin Graft Questions Talk with your Surgeon

I would most certainly speak with your surgeon about your concerns. Anytime you have a question about healing, an in person consultation is necessary.

D.J. Verret, MD
Dallas Facial Plastic Surgeon
3.9 out of 5 stars 14 reviews

How to tell if skin graft is lost?

Your story raises a couple of questions.  Many surgeons will tie a bolster dressing over a skin graft and leave for a week (or longer).  This becomes a bit soiled over the time and hard and can look like drying out skin.  Ocassionally a patient will lose this dressing and assume it's the graft.

Alternatively it is possible that the graft had an infection or poor blood supply and did have a partial or complete NON-Take , that is it didn't get enough blood to live.  This can lead to a depressed scar and may require revision.

Since there are a few possibilities, it is not possible to give a final answer.  This one would be best dealt with in person with your MD

Daniel Berg, MD
Seattle Dermatologic Surgeon
3.7 out of 5 stars 3 reviews

Skin grafting after Mohs surgery

It is very common for a Mohs surgeon to harvest a skin graft to correct the surgical defect created when removing a skin cancer. If the graft does not take, which can happen, I would recommend you show the area to your surgeon so he or she can advise you on local care to the area.

Steven Hacker, MD
West Palm Beach Dermatologic Surgeon
5.0 out of 5 stars 4 reviews

Skin graft healing can vary

Skin "graft" healing can vary depending on the location, thickness, and size.

Contacting your surgeon for an appointment would be a great idea so that you can develop a plan together.

Often special attention to wound care can be very helpful.  The proper care of the graft site can be effective in making the skin heal more quickly and look better in the future. 

Travis T. Tollefson, MD, MPH
Sacramento Facial Plastic Surgeon
5.0 out of 5 stars 5 reviews

Skin Graft Failure after Moh's Reconstruction

Without examination by an experienced surgeon much less a good quality photograph, it is impossible to advise you. Skin grafts can be either PARTIAL or FULL Thickness grafts. Both grafts need to be immobilized to allow blood vessels to grow into the grafts, take it over and nourish it. Graft failure can happen because of failure of this vascular ingrowth or infection. I would suggest you see your surgeon as he would be able to tell you immediately what is going on. Good Luck. Dr. Peter Aldea

Peter A. Aldea, MD
Memphis Plastic Surgeon
4.9 out of 5 stars 108 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.