Full-Thickness Skin Graft Sizing and Scar Quality

This study will compare three different full-thickness skin graft sizes (90%, 100%, and 110% of the surgical defect size) in patients undergoing reconstruction of nasal or ear surgical defects. Participants will be randomly assigned to one of the three graft sizes and followed for 12 months. The study will evaluate scar quality, graft contraction, cosmetic outcomes, patient satisfaction, and complications to determine whether graft size affects healing and final appearance.

Inclusion Criteria: * Age 18 years or older * Undergoing dermatologic surgery resulting in a nasal or auricular defect appropriate for full-thickness skin graft reconstruction * Able to provide informed consent * Willing and able to complete required study follow-up and photography Exclusion Criteria: * Age younger than 18 years * Prisoners * Pregnant women * Non-English-speaking individuals * Concurrent enrollment in another ongoing interventional trial * UAB students or employees * History of keloids or clinically significant hypertrophic scarring * Immunosuppression judged to significantly impair wound healing * Prior radiation therapy involving the recipient site * Active infection at the recipient site * Unable or unwilling to complete required follow-up * Any condition that, in the investigator's judgment, would significantly impair wound healing or make participation inappropriate