Esthetic Skin Graft

This chapter will introduce dermabrasion and dermal resurfacing (overgraft) technique for new aspect concept of esthetic skin grafting. Firstly, it will introduce the different points of skin thickness for each graft site of the body based on the engrafted skin thickness. The key point is finely adjusting the skin thickness depending on the site of the dermal resurfacing, on either parts of the face or forearm and hand. The surgical outcomes of the selection of these sites and the long-term follow-up results will also be introduced. Next, the instruments required for the preparation of the surgery and the manner of their use will be followed. The dermabrasion skills and engrafting techniques essential for performing the surgery will be described, and the postoperative wound dressing methods, complications, postoperative long-term management, and a laser therapy will be introduced with various examples. The outcomes of dermal resurfacing performed on artificial dermis not usual skin autografts bed in special clinical trials will also be shown. In application part, the infinite possibilities and outcomes of dermabrasion and dermal resurfacing with full-thickness skin grafts (FTSG) not thin STSG will be introduced, maximizing the final esthetic effects of the dermal resurfacing. The author performed dermabrasion and dermal overgraft using only thin split-thickness skin graft for simple esthetic purposes in earlier periods but gradually increased the thickness of the skin graft owing to further clinical experience, which ultimately led to the successful result by FTSG. Additionally, it was observed from clinical experiences that overgraft was possible even when performing full-thickness skin attached subcutaneous fat layer.