Surgical strategy for postburn facial scar contracture

Postburn facial scar contracture, which can cause disfigurement and functional impairment, is a major therapeutic challenge. Except for some scars with severe functional impairments such as ectropion of lid, obstruction of nostril, microstomia, and so on, other kinds of facial scars are recommended to be reconstructed after they become sufficiently softened. The selection of specific methods depends on the characteristics of the facial scar. The methods includ direct closure after resection, full or split-thickness skin transplantation, pedicled flap, distant flap, and free flap transfer, and tissue expansion. For the resurfacing of subtotal or total face deformity, composite facial tissue allotransplantation and prefabricated flap combined with tissue expansion and autologous fat injection are increasingly used to improve the facial aesthetic and functional outcome.