Facial postburns scars have always generated a large interest in the general population and stimulated many movie stories, but they remain a source of social exclusion in most of the countries in the world and are a challenge for advanced surgical solutions. Several strategic options have been proposed in the last two decades for patients suffering severe facial scars with a high psychological impact. The tissues of each subunit of the face are specific (eyebrows, front, cheeks, chin, etc.), which makes it difficult for a conventional flap to reproduce this specificity, the different subunits presenting different characteristics in terms of depth, dermal component, softness, and gliding possibilities.
The choice between the different advanced techniques will be limited to a thin partial thickness skin graft, plus a dermal substitute (Integra or Matriderm), a pre-expanded flap coming from the surrounding areas (shoulder, back), or an allogeneic transplantation, which imposes a permanent immunosuppression and whose number is regulated at national levels.
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