ABOUT 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. 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.
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 expand additional skin. Depending on the area to be reconstructed, tissue expansion can take as long as 3 – 4 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 saline that inflates the balloon.
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We prefer the use of a general anesthesia, in which case you’ll sleep through the entire operation. The operative time varies from procedure to procedure depending on the size and area of skin to be expanded. In most cases, the initial operation will take 1 -2 hours. Most tissue expansion is done in an outpatient surgical facility, the size and location of the expansion, will dictate where the surgery takes place and wether overnight stay is required.
The most common concern is rupture/ leak of the silicone expander Though rigorously tested and placed with care, leaks do occur. If the expander should leak, the saline solution, used to fill the expander is harmlessly absorbed by your system and the expander can be 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. The expander may need to be removed for several months until the infection clears. A new expander can then be inserted.
Sameer Karkhanis, MD
Board-Certified Mumbai Plastic Surgeon
Chief Plastic Surgeon & the Director at CCRS is a qualified Aesthetic Plastic and Reconstructive Surgeon. He is Board Certified, with the qualification of DNB Plastic Surgery (Diplomate of National Board). He is an active member of the International Society of Aesthetic Plastic Surgery.