Post burn contracture of lower face and neck, cervicomental reconstruction with triangular dermal fat flap, A new approach.

Deformities of burn scars in chin and upper neck are a tragedy for patients and pose a great challenge to plastic surgeons due to limited available methods for reconstruction of three-dimensional appearance. In this paper we present a new technique for correction of cervicomental angle with a dermal fat flap.

Fourteen patients ages from 18 to 24 years old with extensive neck deformities were enrolled to 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 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 that was reduced to 108.9+6.15° postoperatively. The neck and chin preserved with better contours.

This is a new technique which 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 deformity with obtunded cervicomental angle.