Extensive postburn face and neck contractures, particularly extending bilaterally or to the chest, pose significant reconstructive challenges. This study aims to assess the efficacy and strategies of bilateral pre-expanded supraclavicular artery flaps (SCFs) in addressing these complex defects.

A retrospective study was conducted at our institution from January 1, 2015, to January 1, 2024, encompassing patients who underwent bilateral pre-expanded SCF reconstruction for faciocervical scar contractures. Data on patient demographics, flap characteristics, and postoperative outcomes were collected.

Twenty-one patients (median age, 11 years) underwent reconstruction with 42 pre-expanded SCFs. Indications included bilateral faciocervical scars ( n = 7), full-neck scars ( n = 5), and combined face, neck, and chest scars ( n = 9). All flaps survived completely, with dimensions ranging from 8 cm × 5 cm to 25 cm × 13 cm. At a mean follow-up of 5.85 years, 95.2% of patients (20/21) reported satisfaction with the appearance and texture of the flaps, and all demonstrated improved neck mobility. Complications occurred in 19.0% of flaps (one wound dehiscence, three distal venous congestions), all of which resolved with conservative management.

Bilateral pre-expanded SCFs provide a reliable option for reconstructing extensive faciocervical contractures, including bilateral cervicofacial involvement, entire neck involvement, or with mentosternal adhesions, achieving both aesthetic and functional improvements.