William Callaghan. MD (Tissue-Expansion Surgery)
Tissue expansion is a surgical technique that is used in reconstruction. It is used when there is insufficient tissue to cover a particular area. Most commonly it is used in breast reconstruction following mastectomy, or in post burn reconstruction.
The basic idea is that a silicone “balloon” is placed under the skin adjacent to the area to be reconstructed and sterile saline solution is slowly injected into it to expand the overlying skin. Once the skin is expanded to provide enough tissue coverage the expander is removed and the tissue is used to cover the defect.
Tissue expansion can be performed on people of all ages, but is generally most successful when performed in areas such as the face, neck, scalp, hands, arms, and legs, because the skin is thinner in these areas. It can be more difficult when working with thick-skinned areas like the back and parts of the torso, and may not be possible on areas where the skin is severely damaged or scarred.
- • offers a match of skin color, texture, and sensation .
- • less risk of tissue loss because the skin remains connected to its blood and nerve supply
- • scars are less noticeable than with other techniques, such as skin grafts.
- • expansion can take as long as 3 to 4 months
- • creates an unsightly bulge while in place (such as in facial or scalp reconstruction)
- • requires repeated trips to your surgeon for saline injections to further inflate the expander
- • infection
- • unfavorable scarring and/or skin discoloration
- • excessive bleeding or hematoma
- • skin or fat necrosis (tissue death)
- • poor wound healing or wound separation
- • persistent pain
- • temporary or permanent change/loss of skin sensation
- • unsatisfactory aesthetic results requiring further revision
- • breakage or leaking of the expander
Most patients are able to resume their normal routine within 2 to 4 days of surgery, and maintain their normal activities while the expander is in place. Following the second surgery (to remove the expander and reposition the new tissue), most patients are back to work within a week. Reconstructive procedures vary greatly from patient to patient, and thus, recovery time can vary greatly as well according to your general health and the length and complexity of your procedure.