Reconstruction of burned breasts

Chest wall burn patients usually come with many predictable complaints which are directly related to burn scar such as postural deformity, exercise and daily activity limitations.The most important aesthetic parts of the chest wall are breasts especially in female gender.Chest wall burn of prepubertal girls needs precise F/U for early detection of possible breast growth disturbance when breast budding is happened, and early surgical intervention.On the other hand, breast burn and its deformity in women at reproductive age might lead to wide range of aesthetic problems based on extent and intensity of scar and treatment is planned accordingly.While Minimal superficial scars need no intervention or medical treatment such as laser or topical anti-scar treatment, more extensive scars should be divided into groups based on size, site of scar and breast size to plan for appropriate management:1- Moderate size scars on the periphery of large breasts can be managed with serial excision with or without reduction mamoplasty.2- Extensive scars of breasts in the condition of remaining enough normal skin should be managed with appropriate reduction mamoplasty techniques if possible.3- Extensive scars with significant skin loss which make the reconstruction infeasible with known mamoplasty techniques necessitate recruitment of tissue from adjacent areas before mamoplasty.4- More extensive scars with major loss of breast skin and adjacent tissues need release of deformities and skin graft for better shaping and creation of more aesthetic breasts.5- Absence of NAC is treated with local flap for nipple reconstruction with and tattooing or skin graft for creation of areola.