Tissue Expansion

What is tissue expansion?

If Your Doctor Recommends Tissue Expansion...

Tissue expansion is a relatively straightforward procedure that enables the body to "grow" extra skin for use in reconstructing almost any part of the body. A silicone balloon expander is inserted under the skin near the area to be repaired and then gradually filled with salt water over time, causing the skin to stretch and grow. It is most commonly used for breast reconstruction following breast removal-but it's also used to repair skin damaged by birth defects, accidents or surgery, and in certain cosmetic procedures.

If your doctor is recommending tissue expansion, this will give you a basic understanding of the procedure-when it can help, how it's performed, and what results you can expect. It can't answer all of your questions, however, since much depends on your individual circumstances. Please be sure to ask your surgeon if there is anything you don't understand about the procedure.

The Best Candidates for Tissue Expansion

Almost anyone in need of additional skin can benefit from tissue expansion-from infants to elderly men and women.

The procedure is used widely in breast reconstruction when there is not enough skin to accommodate a permanent implant to restore a woman's natural appearance. It is also an option for repairing or replacing areas of the scalp, where hair growth makes it difficult to replace lost tissue with skin from other areas of the body. Tissue expansion generally produces excellent results when reconstructing some areas of the face and neck, the hands, arms, and legs.

Expansion may be more difficult on the back, torso, or other areas where skin is thick. If the affected area is severely damaged or scarred, expansion is probably not an option since healthy skin is the first requirement.

Advantages and Disadvantages

Until recently, surgeons were limited to skin flaps and skin grafts to reconstruct damaged tissue. Tissue expansion, however, provides an added technique with several advantages.

First, expansion offers a near-perfect match of color, texture, and hair-bearing qualities. Second, because the skin remains connected to the donor area's blood and nerve supply, there is a smaller risk that it will die. In addition, because the skin doesn't have to be moved from one area to another, scars are often less apparent.

On the other hand, skin expansion has one significant drawback - the length of time required to grow additional skin. Depending on the area to be reconstructed, tissue expansion can take as long as three to four months. During this time, the expander creates what can be an unsightly bulge - which is desirable in breast reconstruction, but can be quite noticeable for someone requiring repair of the scalp or other areas of the body. Furthermore, the procedure requires repeated visits to the surgeon for injection of the salt water that inflates the balloon. For some people, the inconvenience and obvious appearance of an expander are enough for them to consider other options.