A Clear Path to Healing: Innovative Facial Burn Recovery

At Shriners Children’s Texas, we are always looking for ways to improve care for patients recovering from facial burns. One of the most important tools in burn rehabilitation is the transparent facial orthosis (TFO), a clear facemask that helps manage scarring during healing. Traditionally, these masks are created by scanning a patient’s face and outsourcing fabrication to an external vendor. While effective, that process can take valuable time during the early stages of recovery.

To better serve our patients, our burn rehabilitation team can fabricate TFO molds in-house using 3D printing technology. By supplementing outsourced production with our own capabilities, we can provide masks earlier in a patient’s hospital stay and significantly reduce turnaround time when urgent needs arise.

The process begins with a scan of the patient’s face to create a detailed digital image. Our team fine-tunes that image on a computer, then uses a 3D printer to create a physical mold of the patient’s face. The mold can be adjusted by hand to ensure pressure is applied in the right areas. A clear plastic material is then shaped over the mold to create the final mask, with openings carefully trimmed for the eyes, nose and mouth.

These masks play a critical role in recovery. Facial scarring can affect far more than appearance; it can interfere with everyday functions like facial expression, eating, breathing and even closing the eyes or mouth.

“Facial scars don’t just change how someone looks, they can change how the face moves and works,” said Chris Whitehead, PT, physical therapist at Shriners Children’s Texas. “If scars tighten too much, they can make it hard to smile, eat, breathe or even close the eyes. TFOs let us see the scar clearly and apply gentle, steady pressure that helps soften the scar and keep the face moving the way it should.”

The TFOs are made from transparent, high-temperature thermoplastic, allowing clinicians to see the scarring underneath and assess how well pressure is being applied. Therapists also use scar rating scales to track changes over time. Patients typically wear their TFO throughout the scar maturation process, which often lasts one to two years. Wearing a mask for long periods can be challenging, as patients may find them hot or uncomfortable, but consistent use is key to achieving the best outcomes.

Because the face changes as healing progresses, TFOs are not a one-time solution. Adjustments, or even new masks, are often needed as swelling decreases, scars soften or children grow. Producing TFOs in-house allows our team to respond more quickly and collaborate closely, reflecting our commitment to innovation and patient-centered care.