A full-thickness skin graft takes skin from a hidden donor site and lays it into the wound. Planned and carried out by Consultant Plastic Surgeon Miss Rakhee Nayar.
of 36 patients would recommend Miss Nayar (PHIN, September 2026)
A free graft
What is a Full-Thickness Skin Graft?
A full-thickness skin graft is a piece of skin taken completely free from another part of the body and laid into the wound left by Mohs surgery.
Unlike a flap, a graft brings no blood supply of its own. It survives by taking up nourishment from the wound bed over the first few days, which is why graft aftercare matters so much.
Choosing the repair
When is a Skin Graft Used?
A full-thickness graft is used when a wound is too large to close directly, but a flap would distort a nearby feature.
It is one of the most common repairs on the nose after removal of a basal cell carcinoma, and is also used on the lower eyelid, the ear and the forehead.
Miss Nayar chooses the donor site specifically to match the colour, thickness and texture of the area being repaired.
The wound is too large to close directly, but a flap would distort a nearby feature.
The wound sits on the side or bridge of the nose, the lower eyelid, the ear or the forehead.
It is better to keep the area flat and easy to monitor.
You would rather avoid the longer, staged surgery a large flap can involve.
Planned around you
Where the Graft Comes From
Donor sites are chosen because the skin is a close match for facial skin, and the donor site itself can be closed as a fine line hidden in a natural crease.
In Front of the Ear
A close match for skin on the nose and cheek, with the line hidden in the natural crease.
Behind the Ear
A well-hidden site that suits many repairs on the face.
The Upper Eyelid
Thin skin, well suited to repairs on the lower eyelid.
The Neck or Inner Arm
Used where a larger piece of skin is needed.
Clinical background
Why Choose Miss Rakhee Nayar for Your Reconstruction?
Reconstruction is where the result you live with is decided. With over 20 years of surgical experience, Miss Rakhee Nayar brings training in both skin cancer surgery and plastic surgery to the same operation.
One Surgeon, Start to Finish
Miss Nayar is one of fewer than 10 women in the UK dual-trained in both plastic surgery and Mohs micrographic surgery.
That means the surgeon who checks your margins under the microscope is the same one who plans and carries out the repair, knowing exactly what has been removed and why.
The Dual-Specialist Advantage
This combination means the person who removes your cancer is the same person who plans and carries out the repair. Miss Nayar is accredited as both a Consultant Plastic Surgeon and a Mohs surgeon.
- Cancer removal with every margin checked
- Repair chosen for your face and your wound
- One consultant from consultation to follow-up
- Plastic surgery training (FRCS Plast)
Training and Appointments
Miss Nayar is a Consultant Plastic Surgeon at Mersey and West Lancashire Teaching Hospitals NHS Trust, and sees private patients at Fairfield Independent Hospital and Circle Cheshire Clinic.
- She chairs the Mohs Surgery Training Interface Group (JCST), the national committee for Mohs fellowship training in the UK.
- She holds an MBChB with Honours and an MD from the School of Cancer Studies at the University of Liverpool.
- She is a Fellow of the Royal College of Surgeons of Edinburgh (FRCS Plast) and holds the European Board of Hand Surgery Diploma (EBHS).
- She is an active member of the British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS) and the British Medical Association.
Where it is used
Where Skin Grafts Are Used
Full-thickness grafts are used where a wound needs cover but the surrounding skin cannot be moved without distorting a feature.
Read about the other reconstruction options: direct closure, healing by secondary intention, local flap, split skin graft, nasolabial flap and forehead flap.
The Side of the Nose
The Bridge of the Nose
The Lower Eyelid
The Ear
The Forehead
Request an e-Consultation
Miss Nayar offers a convenient e-Consultation service for patients seeking a specialist opinion from across the UK and overseas. This secure digital pathway enables remote assessment of skin lesions and concerns, providing a prompt clinical recommendation.
It is an ideal first step for those considering Mohs surgery or reconstruction before travelling for an in-person appointment.
Step by step
What the Procedure Involves
Most repairs are carried out under local anaesthetic on the same day as the Mohs surgery, once the microscope has confirmed the margins are clear. Each step is explained as it happens.
Years of surgical experience
The area is numbed with local anaesthetic, so you stay awake but should not feel pain.
Once the margins are clear, skin is taken from the donor site and the donor site is closed.
The graft is cut slightly larger than the wound and thinned to the right depth.
It is laid in and stitched around its edge.
A firm dressing, sometimes stitched in place, holds the graft against the wound for five to seven days.
Other options
Other Reconstruction Options
A graft leaves a patch rather than a line, so a local flap is generally preferred where a closer match is achievable. These are the alternatives most often considered.
Local Flap
Neighbouring skin moved across on its own blood supply for a close match. Read more
Direct Closure
A fine line of stitches, placed in the natural creases of the face. Read more
Nasolabial Flap
Cheek skin from beside the nose, used to rebuild the side of the nose. Read more
Split Skin Graft
A thinner graft for large wounds, most often on the scalp. Read more
Healing week by week
Recovery and Healing
The first week matters most, because that is when the graft takes up its new blood supply. Miss Rakhee Nayar gives you a clear aftercare plan and sees you again to check it.
- Days 1 to 7: the dressing stays on and dry while the graft takes. This is the most important week.
- Week 1: the dressing and stitches come off. The graft often looks purple, dusky or crusted. This is normal and not a sign of failure.
- Weeks 2 to 6: colour shifts from purple towards pink, and some surface crust separates.
- Months 2 to 6: colour and texture begin to blend, and the edge softens.
- Months 6 to 12: final colour settles. Grafts can stay slightly paler or flatter than the skin around them.
- Where the result at twelve months is not ideal, small refinements such as dermabrasion can help.
In Patients' Words
Patients Feedback
What Our Patients Say
Concerned About Skin Cancer?
Book a Specialist Assessment
Early assessment usually means a smaller operation and a simpler repair. Contact Miss Rakhee Nayar’s clinic for an assessment by a consultant dual-trained in Mohs and plastic surgery.
or Call Us Now
07740 306144
Circle cheshire Clinic
The Courtyard, Hall Ln, Wincham, Northwich CW9 6DG, United Kingdom
07740 306144
contact@mohssurgeon.co.uk
Schedule Your Visit
Where to See Miss Nayar
Miss Rakhee Nayar provides specialist Mohs and reconstructive surgery at Circle Health Cheshire Clinic. This modern, private facility offers expert care in a discreet environment for patients across Cheshire and the North West.
Frequently Asked Questions
We're Always Here to Help You
Why does the graft look purple at first?
In the first week or two, a graft often looks purple, dusky or crusted while it takes up its blood supply. This is normal and is not a sign that the graft has failed.
Can I remove the dressing myself?
No. The dressing holds the graft in close contact with the wound and usually stays undisturbed for five to seven days. It is removed at your follow-up appointment.
Will the graft match my skin?
Closely, because the donor site is chosen to match. A graft leaves a patch rather than a line, so it can stay slightly paler or flatter than the surrounding skin.
Will I be awake for the surgery?
Yes. Most repairs are carried out under local anaesthetic, so you stay awake and can talk to the team throughout. It also avoids the need for a general anaesthetic.
How long will it take?
It depends on how many Mohs layers are needed before the repair, which cannot be known in advance. Plan to be at the clinic for at least half a day.
Will it leave a scar?
All surgery leaves a scar. A graft leaves a patch rather than a line, and the donor site is closed as a fine line hidden in a natural crease.