OBJECTIVES:

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.

ADVANTAGES & DISADVANTAGES:

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.

CANDIDATES FOR TISSUE EXPANSION:

Almost anyone in need of additional skin can benefit from tissue expansion-from infants to
elderly men and women.The procedure is used widely in:














Hair loss following Burns / Trauma : large areas of the scalp with hair loss makes it difficult
to replace and restore, lost tissue with skin from other areas of the body which do not grow
hair. Tissue Expansion is ideal for scalp repair because the local stretched skin on the scalp
retains normal hair growth and  restores a more natural appearance.

CONSULTATION & PREPARATION:

During your initial consultation, we will evaluate your condition. Your age, skin condition,
medical history and other factors will help us determine if you'll benefit from tissue
expansion.

An essential prerequisite is the patients flexibility and tolerance for the inconvenience
associated with this procedure,so feel free to discuss your expectations and your
understanding of it with us.

RISKS & COMPLICATIONS:

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.

HOSPITAL STAY/OUT-PATIENT:

Most tissue expansion is done in an outpatient surgical facility, the size and location of the
expansion, will dictate where the surgery takes place.

ANAESTHESIA:

We prefer the use of a general anesthesia, in which case you'll sleep through the entire
operation.

OPERATING 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.

THE SURGERY:

We will begin by making a small inconspicuous incision next to the area of skin to be
repaired.The silicone balloon expander is inserted into a pocket created beneath the skin.
The expander includes a tiny tube and a self-sealing valve that allows the surgeon to
gradually fill the expander with saline solution. The valve is usually left just beneath the
surface of the skin.

Depending on your skin condition & the site of placement, filling of the expander may
commence immediately or after the wound has healed Once the incision has healed, you'll
be asked to return to our office periodically so that the expander can be injected with
additional saline. 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.

THE RECOVERY PERIOD:

The initial surgery to insert the expander causes most patients only temporary discomfort
which can be controlled with medication prescribed by us.

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.

How soon you resume your normal routine depends on the length, complexity and type of
surgery you've had. Usually, normal activity can resume in 2 - 4 days.

Most tissue expansion patients find they can keep up with their normal routine while the
expander is in place. Following the second surgery, most patients are up and about within a
week.

THE NEW LOOK:
Generally, the results of tissue expansion are superior to other methods used to reconstruct
or repair damaged skin. But keep in mind, the goal is improvement, not perfection.

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Plastic Surgery India
TISSUE
EXPANSION
Breast Reconstruction :  when there is not
enough skin to accommodate a permanent
implant to restore a woman's natural
appearance. The skin is expanded as shown to
make place for  an implant.

To repair skin damaged by birth defects,
accidents or surgery, and in certain cosmetic
procedures. However, if the affected area is
severely damaged or scarred, expansion is
probably not an option, since healthy skin is the
first requirement.