Clinical photograph showing a side-by-side preoperative (left) and postoperative (right) frontal view of a patient with extensive facial scarring and contractures resulting from childhood flame burns. The preoperative image demonstrates significant disfigurement of the mid- and lower face, characterized by lower lip retraction (ectropion), loss of the vermilion border, and obliteration of the natural labiomental and submental folds, leading to a retrusive chin appearance. Severe cicatricial changes affect the skin texture and symmetry of the oral commissures. The postoperative image shows the result of reconstructive plastic surgery involving hinge flaps from subcutaneous fat pads and skin grafting. Key improvements include the restoration of the labiomental crease, increased chin projection (correction of retrogenia), and improved lower lip competence and contour. Although some hypertrophic scarring remains, there is a marked improvement in facial harmony, skin texture, and anatomical landmark definition, specifically regarding the philtrum and chin protrusion.

This clinical photograph displays chemical facial burns on a 45-year-old patient, captured on the third post-burn day. The cutaneous injury exhibits a characteristic 'marble cake' or 'trickle' pattern, with irregular, linear, and patchy hyperpigmented areas interspersed with islands of unaffected skin. The burn coloration ranges from light tan and golden-brown to dark brown and blackish-brown, typical of sulfuric acid-induced coagulation necrosis. The ocular region is significantly involved; the left eye shows marked corneal opacity (leukoma), conjunctival injection, and periocular edema with darkening of the eyelid skin. The right eye appears less severely affected but maintains periocular involvement. Key educational features include the visualization of mixed-depth chemical burns, where superficial and deep partial-thickness areas coexist, and the acute ophthalmic complications following acidic liquid exposure. This image is relevant for surgical burn assessment, emergency medicine, and ophthalmology, illustrating why chemical burns often require delayed depth reassessment due to their evolving nature and non-uniform distribution.

Two-panel clinical photograph illustrating the surgical management and complications of chemical burns to the face and eyelids. Image A shows the left eye of a 45-year-old patient following an initial reconstructive procedure for a severe sulfuric acid burn. Full-thickness skin grafts have been applied to both the upper and lower eyelids. The grafts are secured with visible peripheral sutures, and a clear plastic bolster (stent) is positioned on the upper eyelid to minimize graft contraction. The surrounding periorbital tissue shows significant erythema and hypertrophic scarring. Image B displays a later clinical stage showing bilateral eyelid malposition. The right lower eyelid exhibits severe cicatricial ectropion, characterized by the outward eversion of the eyelid margin and significant exposure of the hyperemic, inflamed palpebral conjunctiva. The left eye shows corneal opacity and further scarring. Extensive, multi-tonal facial scarring with 'trickle' patterns characteristic of liquid chemical burns is visible across the forehead, cheeks, and periorbital regions, demonstrating the long-term sequelae and complexity of managing cicatricial deformities following acid injuries.