Facial reconstruction is one of the most challenging fields in cosmetic and reconstructive surgery. When patients undergo skin transplants to address large facial defects, the surgeon’s goal is to restore both the function and appearance of the face in a way that integrates seamlessly with their natural features. Dr Xusong Luo, Dr Lin Lu and their colleagues at Shanghai Ninth People’s Hospital have developed an innovative approach that offers a promising new option for repairing large facial defects, particularly in children born with giant congenital melanocytic nevi.