The challenge of reconstruction for severe facial burn deformity.

This article presents the story of the development of an expanded transposition flap that evolved from a desire to optimally reconstruct facial burn deformities. The story spans 25 years and demonstrates how an algorithm was developed from its use, and how the algorithm is used to analyze large facial burn deformities and provide a reconstructive surgical decision making tree. The experience suggests that versatility, reliability, and minimization of the donor site defect and reconstructive time are all benefits of this approach.