Objective: Mentosternal contracture, a complication of deep thermal injury to the neck, results in significant functional and esthetic problems. A new method of reconstructing this deformity is described.

Methods: We present a case of a 5-year-old patient with severe mentosternal contracture, treated with a large occipito-scapular island flap (24 cm × 10 cm) augmented by anastomosing the circumflex scapular artery to the facial artery.

Results: A 46% functional improvement in the range of motion was achieved, and an esthetically pleasing appearance was obtained.

Conclusions: This case report demonstrates the occipitocervical dorsal flap to be an excellent option for mentosternal contracture release. Microvascular flap perfusion augmentation should be considered even in cases of limited vascular dimensions as is often seen in the pediatric patient population.