American Society of Plastic Surgeons
For Medical Professionals
 

Tissue Expansion

Growing Extra Skin for Reconstruction

Tissue expansion enables the body to "grow" extra skin for use in reconstructing almost any part of the body.

What are the risks of tissue expansion?

Skin expansion can produce some remarkable results. As with any operation, though, there are risks associated with surgery and specific complications associated with this procedure.

The most common concern is that the silicone expander used in the procedure will break or leak while it is in the body. While expanders are rigorously tested and placed with care, leaks do occur. If the expander should leak, the salt-water solution (also known as saline) used to fill the expander is harmlessly absorbed by your system and the expander is replaced in a relatively minor surgical procedure.

A small percentage of patients develop an infection around the expander. While this may occur at any time, it's most often seen within a few weeks after the expander is inserted. In some cases, the expander may need to be removed for several months until the infection clears. A new expander can then be inserted.

Tissue expansion advantages

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:

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

Tissue expansion disadvantages

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.



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