Tissue-expanded visor flap in burn surgery.

Severe postburn scarring of the lower face in the adult male may cause loss of mustache and beard in addition to other complications. The resulting unacceptable boyish appearance in 3 such patients was treated with tissue-expanded visor flap reconstruction. Complications, which were few, minor, and temporary, included moderate postoperative hematoma, hair-bearing skin loss in the region of the sideburns, and hair growth in an unwanted direction. The flap is safe to perform, with adequate blood supply, and achieved the goal of the operation, which is the restoration of a masculine appearance. The major advantage of this procedure is that the donor site morbidity and alopecia associated with the classic visor flap is virtually eliminated.