Summary: Background: Treatment of burn scars with traditional surgical techniques is challenging due to recurrent contractures. Fat grafting has been previously used in small clinical series and results are often biased by lack of scientific validating methods. Fat grafting in clinical practice is often evaluated for its filler properties and rarely scientifically validated for its potential in dermal regeneration. Animal studies have shown dermal regeneration with new deposition and reorientation of the collagen fiber. Our study aims to apply the validity of in vitro studies to clinical practice. Methods: Our study prospectively evaluated outcomes in 12 patients treated with the “SUFA” technique (Subcision and Fat Grafting) for debilitating contracted burns scars limiting range of motion. Results were evaluated clinically with the Vancouver scale and by range of motion at 1, 3, 6 and 12 months. Dermal regeneration was evaluated by looking at dermis thickening using high definition ultrasound and scar remodeling looking at reorientation and new deposition of collagen fibers with hematoxylin-eosin histology and monoclonal antibodies against collagen type 1 and 3. Results: Statistically significant clinical improvements in range of motion of the affected joints was observed (P
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