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 each, selecting donor areas, harvesting methods, preparing the graft bed, fixing the graft, and what affects successful take and long-term colour and texture matching.
Indications for full-thickness skin graftsIndications for split-thickness skin graftsChoosing facial and extrafacial donor sitesGraft bed preparation and haemostasisGraft fixation, bolsters, and dressingsFactors affecting graft take and contractionLesson 2Anatomy of facial soft tissues: skin, subcutaneous fat, SMAS, facial muscles, and sensory/motor nervesThis part looks at the layered anatomy of facial soft tissues, highlighting skin, subcutaneous fat, SMAS, mimetic muscles, and sensory and motor nerves, to help with safe dissection levels, flap lifting, and keeping expression and sensation intact.
Skin thickness, elasticity, and adnexal structuresSubcutaneous fat compartments and retaining ligamentsSMAS anatomy, continuity, and surgical planesMimetic muscle orientation and functional unitsSensory nerve branches and danger zonesMotor nerve branches and safe dissection corridorsLesson 3Wound assessment and timing: contamination, devitalized tissue, and infection riskThis part discusses thorough wound assessment, covering cause, contamination, tissue viability, and infection risk, and covers when to close wounds, the need for staged procedures, and extras like irrigation, antibiotics, and negative pressure therapy.
History, mechanism, and energy of facial injuryEvaluating contamination and foreign materialAssessing tissue viability and perfusionClassifying wounds and infection risk levelsPrimary, delayed primary, and secondary closureRole of irrigation, debridement, and antibioticsLesson 4Vascular supply and angiosomes of the face relevant to flap design and graft survivalThis part reviews facial arterial anatomy, angiosomes, and choke vessels important for flap design, flap delay, and graft survival, focusing on safe pedicle choices, flap length-to-width ratios, and ways to boost perfusion and cut necrosis.
Facial artery course and key branchesAngular, infraorbital, and transverse facial arteriesAngiosomes, perforasomes, and choke vesselsDesigning flaps along dominant vascular territoriesFlap delay and strategies to improve perfusionOptimising graft beds and monitoring viabilityLesson 5Local flap types and indications: advancement, rotation, transposition, bilobed, island flapsThis part examines main local flap types for facial reconstruction, like advancement, rotation, transposition, bilobed, and island flaps, with focus on when to use them, design rules, movement directions, and avoiding problems.
Principles of random pattern local flapsAdvancement flap design and applicationsRotation flaps and arc of rotation limitsTransposition flaps and pivotal point planningBilobed flaps for nasal and small defectsIsland and V-Y flaps for limited laxity areasLesson 6Principles of debridement and preservation of facial landmarks for aesthetic reconstructionThis part sets out principles for careful debridement while keeping key facial landmarks, stressing gentle tissue handling, staged removal, and planning cuts to keep symmetry, shape, and natural aesthetic lines.
Assessing devitalised versus salvageable tissueSharp debridement techniques on the faceProtecting eyelid, lip, and alar landmarksManaging avulsed tissue and composite graftsPlanning incisions along aesthetic bordersStaged revision and scar refinement strategiesLesson 7Scar placement and minimising aesthetic units: relaxed skin tension lines, aesthetic subunit reconstructionThis part explains aesthetic units and relaxed skin tension lines, guiding where to place incisions, hide scars, and do subunit-based reconstruction to reduce shape issues and improve long-term scar quality in facial soft tissue repair.
Facial aesthetic units and subunits mappingRelaxed skin tension lines and incision planningNatural creases and border camouflage strategiesSubunit excision and replacement principlesManaging scars across junctions and transitionsSuture selection and closure tension controlLesson 8Management of periocular soft tissue injuries: lower eyelid anatomy, canthal support, risk of ectropionThis part details periocular soft tissue anatomy, 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 anterior and posterior lamellaeMedial and lateral canthal tendon anatomyEctropion risk factors and preventionFlap design and tension vectors in eyelidsCanthopexy and canthoplasty techniquesPostoperative ocular protection and careLesson 9Tissue loss classification and decision framework: primary closure, delayed closure, graft, local flap, regional flapThis part presents classification of facial tissue loss by depth, size, and involved structures, and gives a step-by-step decision guide 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 laxity and tissue availabilityIndications for primary versus delayed closureWhen to choose grafts over local flapsLocal versus regional flap selection criteriaPatient comorbidities 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 periorbital and nasal reconstruction, reviewing graft materials, shaping and fixing techniques, and ways to restore shape, airway openness, and eyelid stability while hiding visibility.
Sources of septal, auricular, and costal cartilageCartilage graft shapes for nasal frameworkLower eyelid spacer graft indicationsFixation methods: sutures, pockets, and tunnelsMaintaining airway and valve functionCamouflaging graft edges and contour refinements
