Tissue expansion procedure steps
Where Your Surgery Will Be Performed
While most tissue expansion is done in an outpatient surgical facility, the size and location of the expansion, as well as the preference of the patient and surgeon, will dictate where the surgery takes place.
Your surgeon may begin tissue expansion immediately at the time of breast removal. If you've had an injury, on the other hand, your surgeon will probably recommend that tissue expansion be performed in an outpatient surgical facility after the wound has healed.
More and more frequently, surgeons are performing tissue expansions on an out patient basis for cost savings and convenience.
Types of Anesthesia
Your surgeon may use local anesthesia, combined with a sedative to make you drowsy. You'll be awake but relaxed, and should feel little discomfort. Your surgeon may recommend the use of a general anesthesia instead, in which case you'll sleep through the entire operation.
In most cases, the initial operation will take one to two hours, depending on the size and area of skin to be expanded. Your surgeon will begin by making a small incision next to the area of skin to be repaired, and will do everything possible to make the incision as inconspicuous as possible.
He or she will then insert the silicone balloon expander in a pocket created beneath the skin. The expander includes a tiny tube and a self-sealing valve that allows the surgeon to gradually fill the expander with saline solution. The valve is usually left just beneath the surface of the skin.
Once the incision has healed, you'll be asked to return to your surgeon's office periodically so that the expander can be injected with additional saline. As the expander enlarges, your skin will stretch. In some people, this procedure can causes minor discomfort.
When the skin has stretched enough to cover the affected area, you'll have a second operation to remove the expander and reposition the new tissue. In breast reconstruction, the surgery required to remove the expander and insert the permanent implant is relatively brief. More complex surgery to repair skin on the face or scalp will take longer, and may require more than one expansion sequence to complete.
Example 1: Scalp
Tissue Expansion is ideal for scalp repair because the stretched skin on the scalp retains normal hair growth. Most other body tissue does not grow hair to the same degree.
Example 2: Breast
A silicone balloon expander is inserted beneath the skin. Once in place, the expander is gradually filled with salt water through a tiny valve. When the tissue has grown to the desired amount, the expander is removed. In breast reconstruction, a permanent implant is then inserted.
Example 3: Arm
Expansion is also used to repair skin on the head and neck, hands, arms, and legs.