INTRODUCTION Contour deformities in the head and neck pose a unique reconstructive challenge for the reconstructive surgeon. Dermal substitutes are an alternative to autologous tissue to reduce donor site morbidity. Reconstruction of contour with dermal substitutes in the head and neck, remains poorly defined. We conduct a systematic review of the literature to determine the outcomes of tissue defect reconstruction with dermal substitutes, in the return of contour. METHODS A systematic review of the literature was performed. The search was conducted on MEDLINE, EMBASE and Cochrane databases using terms and their synonyms, “dermal substitute” and “contour defect”, to identify studies assessing the contour outcomes of bioengineered dermal substitutes in surgical reconstruction of soft tissue defects in the head and neck. Full text studies published in English were included. Screening of articles for inclusion and exclusion was performed successively by assessing article title, abstract, followed by full text. Analysis of the outcome of redefinition for patients, was performed. RESULTS 19 studies included in the study. Study types ranged from case series to cohort studies. 336 patients with contour deficit in the head and neck were identified. Most soft tissue defects were a result of ablative oncological surgery or parotidectomy, others were due to congenital defects, soft tissue atrophy and cosmetic deficits. All cases of contour deficit were reconstructed with dermal substitutes and had an improvement in form and volume deficit following use of the dermal matrix. CONCLUSION Complex soft tissue defects remain both a creative and logistical challenge for the reconstructive surgeon. Dermal substitutes provide an alternative option for the reconstruction of soft tissue defects to achieve return of form and function, compared with autologous options. Future focus on long term outcomes of contour reconstruction and comparison between dermal substitutes would progress the current body of literature that may be applicable to patient care.