Facial scars after burns lead to social and psychological impact on patient's well being besides the physical deformity.

1. It also causes difficulty in speech and eating due to stretched lips and chin.
2. In case of eyelid contractures, patient is unable to close eyes to some extent or completely which leads to irritation of eyes and cornea and in long term may cause blindness.
3. Sometimes nose burn may cause airway obstruction and difficulty in breathing.
4. Scar over the face can lead to more cosmetic deformity which hampers their day-to-day lifeand can result in low confidence and self esteem
5. Loss of eyebrows, ear and presence of scar bands on face make them always hide their face even from their family members.

All these problems call an early and adequate treatment for the scar of face to allow the patient lead a better life.

Treatment depends on severity and site of the condition.

1. Most of the cases can be treated by a Plastic Surgeon by Z-plasty, skin graftingor local flaps from the adjacent normal skin.
2. Large, scarred areas require replacement of scarred skin by adjacent normal skin where tissue expanderscome into function. After tissue expansion, a drastic and satisfactory change occurs in the appearance and functional outcome.
3. Eyelid contracturestake priority over others and should be treated on urgent basis. The scars are releasedover the eyelid region and the area is covered with skin graft.
4. Outward stretching of the lips can be corrected by release and skin grafting.
5. Ear can be reconstructed with the help of prosthetic ear or carved from one's own rib cartilage.
6. Hair transplantation can be done for loss of eyebrows

Usually single procedure is not enough in cases of major burns of face and multiple stages procedures are required to reconstruct the face completely.

It is rarely possible to provide completely normal physical appearance in severe burn cases but the functional outcome should be provided optimally to make patients daily life better.

The patient is admitted a day before surgery and his/her all routine pre surgery investigations are done. During the surgery, the scars are excisedas per the requirement and the resultant raw area is covered with skin graft or flapfrom the adjacent area. If tissue expanders are used, then it is a 2 staged procedure. In first stage, appropriate size tissue expander is inserted in the adjacent normal skinwhich is regularly expanded after the surgery on day care basis. When the expander has sufficiently expanded the overlying skin, second stage surgery is done and the expander is removed. The resultant extra skin is used to cover the defect after scar excision.

After the surgery, patient is kept in the hospital for 2 to 3 days. The first dressing is usually done after 7 days and then regular follow up is done weekly. Once the area has completely healed, preventive measures should be taken to minimise scars on face. These measures include regular massage with coconut oil, creams and avoidance of sun.