Tissue Expansion

Tissue expansion is a 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 and grow. It is most commonly used for breast reconstruction following breast removal, but it is also used to repair skin damaged by birth defects, accidents or surgery and in certain cosmetic procedures.
The procedure is used widely in breast reconstruction when there is not enough skin to accommodate a permanent implant to restore a woman’s natural appearance. It is also an option for repairing or replacing areas of the scalp where hair growth makes it difficult to replace lost tissue with skin from other areas of the body. Tissue expansion generally produces excellent results when reconstructing some areas of the face, neck, hands, arms and legs.

Expansion may be more difficult on the back, torso or other areas where skin is thick. If the affected area is severely damaged or scarred, expansion is probably not an option since healthy skin is the first requirement.

In most cases, the initial operation will take one to two hours, depending on the size and area of skin to be expanded. Dr. Fisher will begin by making a small incision next to the area of skin to be repaired. He 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 him 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 willl be asked to return to our office periodically so that the expander can be injected with additional saline. As the expander enlarges your skin will stretch. When the skin has stretched enough to cover the affected area you will 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.

After the procedure, you may feel some minor discomfort each time saline is injected into the expander, but this usually lasts only an hour or two. The follow-up procedure to remove the expander and put the new tissue in place may create some temporary discomfort, but this too, can be controlled with medication.