Skin Graft on Nose Driving Me Nuts: What Are the Causes and What to Do?

By - Dr. Afifa Amer

So you have a skin graft on your nose, and it’s bothering the hell out of you. Let me guess, you are feeling a slight pull on your skin, but no such thing is actually happening. 

So, what’s going on here? 

When you have a squamous cell removed from another part of your body and attached to your nose, the nerves don’t get enough time to settle in. 

While your nerves are degenerating, you are feeling weird on your nose. I know it can be really annoying.

Can you remove the skin graft to get rid of all these irritations? What are the options available for you? Most importantly, is it a safe procedure? 

You will know everything by the time you are done with this article. So, make sure to give this write-up a thorough read.

Types of Skin Grafts You See on Your Noses

Two types of grafts are commonly used for the skin on your nose. 

These processes are called full-thickness skin graft (FTSG) and split-thickness skin graft (STSG). While both surgeries are effective if perfectly executed, FTSG is more widely recommended for the nose. 

Chances are, the skin graft you see on your nose was implanted through FTSG. 

Let’s dive deeper into these two surgical procedures:

Full-Thickness Skin Graft (FTSG)

In this process, the surgeon takes the epidermis and the entire dermis from a part of your body to implant it on your nose. Apart from the nose, this process fixes other highly visible areas such as eyelids and ears. 

The epidermis is the upper layer of the skin. At the same time, the dermis is the skin layer that lays just beneath the epidermis. It’s also known as the ‘real skin.’ 

The epidermis and dermis combine into what we call ‘skin.’ Implanting this skin into any body part can effectively conceal any wounds. This is why the procedure is deemed ideal for mending visible areas. 

However, as the process involves healthy and thick skin, it takes more time to heal properly. In addition, the success rate is not that impressive as well. 

Although, working on small portions, such as on the nose, reduces the chance of failure. 

Here’s how the process is executed:

Usually, the donor site is the ear rime, the neck, the shoulder, or the collar area. In either case, it can take a few months to a whole year for the skin to return to its original look. 

After the FTSG process, there will be swelling within the first 24 hours. The blood supply connection will establish within the 3 days of the procedure. 

Restoring the blood supply will take 3 to 4 more days. And you are likely to get your sensation back around 2 to 4 weeks after the surgery. Irritating itching is quite common around this time.

Split-Thickness Skin Graft (STSG)

Though not usually recommended, STSG is another technique for executing the skin grafting procedure. This process is also known as ‘partial-thickness graft.’ 

In contrast to FTSG, this process uses a larger portion of the epidermis and a smaller dermis area.

As you know by now, FTSG is used to mend smaller areas. But if the wound on your nose is too large, the surgeon may prefer STSG. Doctors generally use a skin flap to cover the wound with adjacent skin. 

This way, the blood supply remains intact in that body part, healing the wound quicker than FTSG. In this process, the donor site takes less than 3 weeks to heal properly. In addition, a donor site can be repeatedly used once it’s healed.

A downside of STSG is it shrinks the wound bed. Mainly for this reason, STSG is not ideal for visible body parts. But when the wound of your nose is of significant size, the surgeon is likely to consider STSG for you. 

While using the adjacent skin is a popular option for STSG, there are other graft sources as well. Such as:

Isograft is more commonly recommended unless there’s an extreme situation (such as a third-degree burn). Autograft helps to fasten up the blood circulation process, leading to quick healing. 

Apart from these, there is Composite graft. But you won’t see it on your nose. A composite graft is used on lost muscle and bones.

Is a Skin Graft on Nose Harmful?

Unfortunately, there’s risk in almost all surgical procedures. But if perfectly executed, a skin graft should not harm you. Still, there are some risks involved. Knowing about the potential danger can prepare you better for the procedures. 

Here are the complications of skin graft surgery:

Pus or Blood

After a few days of skin transplant, you may notice pus or blood pooling right under the grafted skin. This usually results from infection or can be a sign of infection. 

Not cleaning the donor skin or the wound area properly before setting the skin is the main reason behind this condition. However, a loose stitch can also be a reason why blood pools underneath the skin. 

Graft Site Injury

Graft site injury can cause a great deal of damage. In addition, if the transplanted skin moves too much before it’s adequately healed, chances are: This will bring more trouble.

Not only will the wound get worse, but there will also be an infection. The only solution in this situation is getting a new transplant. 

Unhealing Wounds

If you have a low level of platelets or an insufficient amount of plasma in your body, then you got a problem. Low platelet levels will delay the healing process. During this period, the transplanted skin may get loose. In fact, this condition can lead to infection as well. 

Pain Sensitivity

A skin graft can drastically increase your pain sensitivity. This problem occurs if the skin tissue is wrongly transplanted or the donor skin is not sufficiently thick. 

Either way, you will have a sensitive nose, which will also itch. The solution here is to get another transplant and fix the issue. 

Apart from these, skin grafts can cause bleeding, contracture, discolored skin, loss of pain sensation, etc. But you shouldn’t have to worry about any of these if the procedure is handled correctly and perfectly maintained.   

When Should You Get Skin Graft on Nose?

Getting a skin graft is a serious issue. You should consider it only if the situation is beyond your control. 

Although an expert surgeon can check your condition and announce whether you need a skin graft or not, it can be helpful to know when it becomes a necessity. 

Wounds

A noticeable wound is the most common reason people get skin grafts on their noses. In addition, accidents can pull out a chunk of flesh from your nose. In those situations, your nose looks grotesque. 

Not only that, but keeping the wound open is likely to invite infections. So overall, it’s wise to cover the wound with fresh skin from other parts of your body and conceal it. This will not only hide the damage but heal your nose quicker.

Burns

The most reported case of skin graft comes from burns. You must get a skin graft to heal your muscles if the burn only affects the nose or whole body. It is rare, but not impossible to need just a nose skin graft due to burning.

Cosmetic Reasons

Many people get skin grafts on their nose if that particular skin is deformed. Birth-mark, permanent marks, and moles also drive people to get skin grafts on the nose. 

Skin Cancer Surgery

As the name suggests, skin cancer cells remain in the skin. A skin graft removes the cancerous cell, preventing the disease from spreading throughout the body. Skin graft on the nose becomes mandatory if cancer cells are found on the nose.

Infections

It is possible to have the infection under the skin of your nose even if the area is not exposed. Whatever the reason, the solution here is to peel off the skin and cure the infectious area. 

However, when a small body part, such as the nose, get’s infected, it damages the adjacent skin. This is why infection in the nose may require removal of the skin. 

In other words, a nose infection is another reason why you need a skin graft. 

Surgery

Sometimes it’s not possible to close a wound after surgery. For example, you are likely to get a skin grafting on the nose if you had nose surgery. Well, a skin graft applies only if the wound on your nose is big enough. 

Apart from these, there aren’t many reasons to get a skin transplant on your nasal area. 

How to Remove Skin Graft Surgically?

Skin graft surgery is a reasonably simple procedure. Although it doesn’t mean you can perform it at home. However, knowing how the process goes can mentally prepare you before the main event. Here’s how it’s done,

Step 1: Choosing the Donor Site

The procedure starts with choosing the donor site. As you have probably already guessed, the donor site is the area where the skin for the graft will be taken from. 

Usually, the donor site is the neck for skin grafts on the nose. The skin of the neck is best compatible with your nose because it’s adequately thin.

Step 2: Preparing the Donor Site

Now you will be put under anesthesia. The surgeon will anesthetize both the donor site and the target area. It means your nose and your neck will be sedated.

The preparation will be complete after the doctor marks the area of the donor site. 

Step 3: Removing the Skin from The Donor Site

Once your donor site is ready to use, the doctor will remove the skin. The process is just what it sounds like. Here the surgeon will take a scalpel and slice a thin layer of your skin. 

The doctor will cover the donor area after removing the skin. A thorough dressing keeps the donor site healthy and free from risks of infections. 

Step 4: Putting the Skin on the Wound

Now comes the vital part of the process. First, the surgeon will put the skin on the wound and stitch it there. This is followed by dressing the spot. 

Finally, the process is complete. As you already know, the skin will slowly heal after this, making your nose look natural again.

What are the Side Effects of Skin Graft?

Skin graft doesn’t usually show severe side effects or anything as such. However, if the surgery is poorly done or the wound is not cleaned correctly, few complications may arise. But even if the process goes smoothly, there are some common side effects.  

Knowing about them can prepare you better. Check them out below:

Bleeding 

The first day of surgery comes with swelling in the grafted area. There is a high risk of bleeding during the first few days. Though it greatly depends on the perfectness of the procedure, your blood circulation rate has a significant role to play here as well. 

Headache

The nose is technically on your head. So anything happening to it will definitely affect the area. Moreover, a part of the skin grafting process is nerve degeneration. You can have a severe headache while your nerve establishes a connection between them.  

However, if you are lucky enough, you won’t have to tolerate such trouble. 

Increasing Pain

A bitter truth is that the grafted area will hurt. Not only the muscle but the bones are also affected when there is a wound. Even if you transplant a new sheet of skin on the wound, the area will still ache. 

But don’t worry because your doctor will make sure to give you painkillers to take care of it. 

Fever

Your whole physical system gets super excited whenever a wound in your body. The bigger the wound, the more blood circulation flows to heal the gap. 

This process heats your whole body. For this reason, you may have a fever after getting a skin graft on your nose. 

Why? A skin graft is basically fiddling with wounds. In other words, you are creating more wounds to heal it. This excites the body, and, as a result, you end up with a fever. 

Apart from these general side effects, you may also experience nausea, vomiting, chest pain, fatigue, lightheadedness, and itching on your skin. In either case, don’t hesitate to consult your doctor for relief. 

My Last Two Words on the Topic

Getting a skin transplant of the nasal area is not as scary as it sounds. But skin graft can drive you nuts in certain situations. You know what those reasons are if you gave this article a read. 

In addition, you are now also aware of when skin graft is the best treatment, what is involved in the surgical procedure, and what the complications of the whole process are. 

Simply put, you are now entirely ready to handle any issues related to the skin graft on your nose.