Resurfacing of lower face scars with a pre-expanded flap from the neck

Postburn scars of the lower face often cause serious deformities and dysfunction. Conventional methods including skin grafts and free flaps always lead to unsatisfactory outcomes. In this article, we describe a series of 8 patients with scars of the lower face treated with an expanded neck flap. Tissue expanders were implanted into the neck and inflated for 3 to 5 months. The expanded flap was then advanced cephalically to resurface the scars of the lower face. The mean follow-up period was 13 months. All 8 flaps survived well except 2 patients developed slight necrosis at the distal edge. The flaps were well matched to the surrounding skin with respect to color, texture, and thickness. The cervicomental angle appears normal. The range of mouth opening increased. In patients with lower face scars and a sufficient unharmed neck flap, use of a pre-expanded neck flap was suitable.