BACKGROUND Facial scars caused by burns and trauma severely affect patients' function and appearance. The expanded deltopectoral flap to local shift is the traditional method of repair, but for patients with the compulsive position after pedicle transfer, the therapeutic outcome is not satisfactory. The authors explored the surgical procedures for repairing facial scars by using the free expanded deltopectoral flap, which can reduce patient suffering and ensure a satisfactory outcome. METHODS Eighteen patients with large facial scars underwent repair using free expanded deltopectoral flaps. After expansion, the flaps were transplanted to repair facial scars by vascular anastomosis. If the contour was not good and the pedicle was clumsy, another operation to thin the flaps was performed to perfect the repair. RESULTS The 18 patients achieved satisfactory results. All of the flaps survived and the skin color, texture, and contour were well matched to those of the peripheral tissue. Six months postoperatively, the flaps had partially recovered sensation, and no adverse effect on facial expression was detected. One patient experienced venous congestion but the flap was successfully salvaged; another patient experienced expander exposure because of infection during saline injection. The asymmetric position of the nipples during the early phase improved gradually over time. CONCLUSIONS After expansion and free transplantation, the deltopectoral flap has proved to be more effective than flaps used traditionally and will become one of the best choices for the treatment of facial scars. METHODS Therapeutic, V.