Does Reconstructive Surgery Improve Psychological Recovery After Burn Injury?

Burn reconstruction aims to restore function, comfort, and appearance, but its effect on psychological recovery remains less certain. This narrative review aimed to examine depression, anxiety, post-traumatic stress disorder (PTSD), demoralization, body image, social participation, post-traumatic growth (PTG), neurocognitive recovery, and health-related quality of life (HRQoL) after burn reconstruction. PubMed/MEDLINE was searched from inception to September 17, 2026, with citation chaining and targeted searches for reconstructive modalities and validated outcome instruments. The evidence is heterogeneous and predominantly observational. Contracture release and laser scar treatment consistently improve selected functional, symptom, and burn-specific quality-of-life outcomes. Autologous fat grafting is promising for scar quality and satisfaction, but comparative evidence remains limited. In contrast, large Burn Model System analyses do not demonstrate consistent improvements in broad mental-health scores among survivors undergoing later surgery; these adjusted associations identify ongoing vulnerability but do not establish that reconstruction causes psychological harm. Depression, anxiety, PTSD, demoralization, body-image distress, and cognitive impairment should therefore be measured as distinct outcomes rather than inferred from scar appearance or generic HRQoL. The most defensible model is one of integrated care: reconstructive surgery combined with rehabilitation, trauma-informed communication, realistic expectation setting, psychological screening, active follow-up, and timely mental-health referral. Future studies should use procedure-specific preoperative baselines, repeated assessments, appropriate comparators, Burn Care Quality Platform (BCQP) variables, and validated burn-specific participation and scar-impact measures.