Postburn facial resurfacing with a split ascending neck flap

Ninety-eight patients with postburn facial scar deformities were treated by using a split ascending neck flap. Anatomic studies and discovery of axial blood supply to the anterior of the neck are utilized, allowing for wide mobilization, thin flaps, and transfer of neck skin to the face and chest skin to the neck. By leaving the platysma muscle in situ and using vacuum drainage with a large tube in the subflap space, preservation of the chin and neck contours is obtained. There are five varieties of postburn facial scar deformities described and treated. Extensive facial deformity requires a two-stage operation. Neck skin transferred to the face by the described method preserves all natural properties. This method of facial resurfacing is preferable to other methods and is indicated for all cases of scars to the face with healthy neck skin and chest wall.