Post Burn Contracture of Lower Face and Neck, Cervicomental Reconstruction With Triangular Dermal Fat Flap: A New Approach

Abstract

Deformities of burn scars in the chin and upper neck are a tragedy for patients and pose a great challenge to plastic surgeons due to limited available methods for the reconstruction of three-dimensional appearance. In this paper, we present a new technique for the correction of cervicomental angle with a dermal fat flap. Fourteen patients ages 18 to 24-year-old with extensive neck deformities were enrolled in the study. During the operation, first, we deepithelialized a triangular scar area in the upper neck, then created a dermal fat flap and flip it up to the chin, restoring the chin shape and volume, after that for subsequent reconstruction of cervicomental angle, after releasing skin from lateral sides of the triangle defect, we approximated the AB and AC line to the upper edge of the defect by V-Y advancement. The remaining defect is covered with a full-thickness skin graft. In all cases, the chins were reshaped with a dermal fat flap. The mean cervicomental angle was 144+14.6° preoperatively, which was reduced to 108.9+6.15° postoperatively. The neck and chin were preserved with better contours. This is a new technique that has never been described before in the literature, and it is innovative compared to the traditional techniques. Good cosmetic outcomes make this technique preferable for all burn neck deformities with an obtunded cervicomental angle.