[Face rehabilitation for post-burn deformities]

Severe post-burn sequelae of the face can result from deep initial burns or inappropriate (initial or secondary) treatment. They still remain a surgical challenge, leading to both aesthetic and functional diseases. The acute treatment is preventive, and usually consists in early split thickness skin grafts from the scalp, while full thickness skin grafts and local flaps are employed for the sequels. Our surgical treatment consists in scar replacement using expanded supraclavicular skin. Depending on the location of the scars and depending on available skin, surgical procedure can use expanded full thickness skin graft or expanded advancement flaps. Some "aesthetic" procedures like lipofilling, rhinoplasty or botulinum toxin can be performed in order to improve the final aspect. Good aesthetic and functional results are usually obtained if fundamental rules are respected: preservation of aesthetic units of the face, good management of skin availability. In any case, whatever techniques are employed, numerous surgical procedures and months of rehabilitation are necessary to achieve good cosmetic and functional results.