Lesson 1Grafts: full-thickness versus split-thickness skin grafts—indications, donor sites, take factorsThis part compares full-thickness and split-thickness skin grafts, explaining when to use them, choosing donor sites, how to harvest, prepare graft bed, fix it, and factors affecting graft take and long-term colour and texture match.
When to use full-thickness skin graftsWhen to use split-thickness skin graftsChoosing donor sites on face and elsewherePreparing graft bed and stopping bleedingFixing graft, bolsters, and dressingsFactors affecting graft take and shrinkingLesson 2Anatomy of facial soft tissues: skin, subcutaneous fat, SMAS, facial muscles, and sensory/motor nervesThis part looks at layered facial soft tissue anatomy, stressing skin, fat under skin, SMAS, face muscles, and sensory and motor nerves, to guide safe cutting planes, flap lifting, and keeping expression and feeling.
Skin thickness, stretch, and attached structuresFat compartments under skin and holding ligamentsSMAS structure, connections, and cutting planesFace muscle direction and working unitsSensory nerve branches and danger areasMotor nerve branches and safe cutting pathsLesson 3Wound assessment and timing: contamination, devitalized tissue, and infection riskThis part covers checking wounds step by step, including how it happened, dirt, tissue life, and infection chance, and explains when to close, need for steps, and extras like washing, antibiotics, and negative pressure therapy.
History, how injury happened, and energy in facial injuryChecking dirt and foreign thingsAssessing tissue life and blood flowClassifying wounds and infection risk levelsClosing right away, later, or secondaryRole of washing, cleaning, and antibioticsLesson 4Vascular supply and angiosomes of the face relevant to flap design and graft survivalThis part looks at facial artery structure, angiosomes, and choke vessels for flap design, flap delay, and graft survival, stressing safe pedicle choice, flap length-to-width ratios, and ways to improve blood flow and reduce death of tissue.
Facial artery path and main branchesAngular, infraorbital, and transverse facial arteriesAngiosomes, perforasomes, and choke vesselsDesigning flaps along main blood areasFlap delay and ways to improve blood flowImproving graft beds and checking lifeLesson 5Local flap types and indications: advancement, rotation, transposition, bilobed, island flapsThis part studies main local flap types for facial rebuilding, including advancement, rotation, transposition, bilobed, and island flaps, focusing on when to use, design rules, movement directions, and avoiding problems.
Rules of random pattern local flapsAdvancement flap design and usesRotation flaps and rotation arc limitsTransposition flaps and pivot point planningBilobed flaps for nose and small defectsIsland and V-Y flaps for areas with little stretchLesson 6Principles of debridement and preservation of facial landmarks for aesthetic reconstructionThis part outlines rules for careful cleaning while keeping key facial landmarks, stressing gentle tissue handling, step excision, and planning cuts to keep symmetry, shape, and natural aesthetic lines.
Checking dead versus savable tissueSharp cleaning techniques on faceProtecting eyelid, lip, and nose wing landmarksManaging torn tissue and composite graftsPlanning cuts along aesthetic bordersStep revision and scar improvement strategiesLesson 7Scar placement and minimizing aesthetic units: relaxed skin tension lines, aesthetic subunit reconstructionThis part explains aesthetic units and relaxed skin tension lines, guiding cut placement, scar hiding, and subunit rebuilding to reduce shape problems and improve long-term scar quality in facial soft tissue repair.
Facial aesthetic units and subunits mappingRelaxed skin tension lines and cut planningNatural creases and border hiding strategiesSubunit excision and replacement rulesManaging scars across joins and changesSuture choice and closure tension controlLesson 8Management of periocular soft tissue injuries: lower eyelid anatomy, canthal support, risk of ectropionThis part details soft tissue anatomy around eyes, lower eyelid layers, canthal tendon support, and factors leading to ectropion, guiding flap design, tension directions, and canthal fixing to keep eyelid position and eye protection.
Lower eyelid front and back layersMedial and lateral canthal tendon structureEctropion risk factors and preventionFlap design and tension directions in eyelidsCanthopexy and canthoplasty methodsPostoperative eye protection and careLesson 9Tissue loss classification and decision framework: primary closure, delayed closure, graft, local flap, regional flapThis part shows classification of facial tissue loss by depth, size, and parts involved, and outlines step decision framework for choosing primary closure, delayed closure, grafts, or local and regional flaps based on defect and patient factors.
Defect size, depth, and structure involvementAssessing skin stretch and tissue availabilityWhen for primary versus delayed closureWhen to choose grafts over local flapsLocal versus regional flap choice criteriaPatient health issues and aesthetic prioritiesLesson 10Cartilage and structural support in periorbital and nasal reconstruction: graft choices and fixation principlesThis part deals with cartilage and structural support in around-eye and nose rebuilding, reviewing graft materials, shaping and fixing methods, and ways to restore shape, airway openness, and eyelid steadiness while hiding visibility.
Sources of septal, ear, and rib cartilageCartilage graft shapes for nose frameLower eyelid spacer graft when to useFixing methods: sutures, pockets, and tunnelsKeeping airway and valve functionHiding graft edges and shape improvements
