Reconstruction of the burned breast

Fundamental principles of management of breast burns begin with recognition and preservation of any viable breast bud tissue. Reconstruction begins wh en the burned breast envelope is insufficient to allow unrestricted breast development. Complete contracture release is obtained by incision or excisi on of the restricting burn scar and thick split-thickness grafting. Occasio nally, breast mound reconstruction with regional musculocutaneous flaps or tissue expanders is necessary Balancing procedures such as reduction or mas topexy of an opposite unburned breast are often helpful. After a period of 6 to 12 months of compression garments, scar management, and settling, nipp le-areola reconstruction is undertaken, and consists of a combination of lo cal flaps, full-thickness grafting, or composite grafts tailored to each pa tient's needs. Long-term follow-up is necessary to ensure that breast devel opment continues satisfactorily and that contractures do not occur.