Aesthetic and Functional Reconstruction of the Postburn Contracture in the Lower Face and Neck Area using Free Radial Forearm Flap

Kwon, Oh Kyoung; Lee, Jong Wook; Jang, Young Chul; Oh, Suk Joon

Abstract

Often, the burn injury has produced deformities both of the facial contour and the facial cover. The hypertrophic burn scar contracture of the lower face and neck is problematic because it distress the patients, functionally and esthetically. In the correction of the lower face and neck deformities, we should focus our attention not only on the restoration of the normal form and function, but also on the achievement of more beautiful appearance. When there was no available skin adjacent to the deformed area, we reconstructed the deformities with free radial forearm flap. So we can restore the deformed face to near normal shape and get good skin quality with these flaps. There were no remarkable complications after surgeory in all cases. To get better outcome of surgery, we have to consider some points. 1) The release and resurfacing of the neck contracture should be carried out in advance. 2) The lowest margin of the flap should be limited, to at least one-finger breadth above the hyoid bone because low setting of the flap deteriorates the cervicomental angle. 3) Adhesion between the flap dermis and the defect bed may be necessary for reconstruction of dumbbell shaped lower lip subunit. Flaps did not look completely normal, but those were compatible with adjacent skin. We could have an adequate functional resurfacing and optimal esthetic outcomes while minimizing recurrent contracture.