What are the steps of a tissue expansion procedure?

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 insert the silicone balloon expander in a pocket created beneath the skin. The expander includes a self-sealing valve or gas cylinder that allows the surgeon to gradually fill the expander with saline or carbon dioxide.

Expander enlarges

Once the incision has healed, you'll be asked to return to your surgeon's office periodically so that the expander can be filled. As the expander enlarges, your skin will stretch. In some people, this procedure can cause minor discomfort.  The expander is filled by inserting a needle into the self-sealing valve, which may be under the skin, or by using a remote dosage controller to fill the expander with carbon dioxide.

Secondary operation

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 over time. 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.