Tissue Expansion Redlands CA
Tissue expansion 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’s also used to repair skin damaged by birth defects, accidents or surgery, and in certain cosmetic procedures.
The best candidates for tissue expansion
Almost anyone in need of additional skin can benefit from tissue expansion.
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 and neck, the hands, arms, and legs.
Tissue expansion is ideal for scalp repair because the stretched skin on the scalp retains normal hair growth. Most other body tissue does not grow hair to the same degree.
Following tissue expansion, the repaired scalp looks very natural. 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.
Advantages and 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 grow additional skin. The process usually takes 3-4 months total, in which time there may be a visible bulge. Also, the procedure requires repeated visits to the surgeon for injection of the salt water that inflates the balloon.
Despite the drawbacks, tissue expansion can produce very pleasing results, and is a superior technique for its reconstructive purpose.
Although expanders are thoroughly tested and carefully inserted, leaks can occur. If the expander leaks, your body will harmlessly absorb the saline solution. Minor surgery is required to replace the expander. Rarely, an infection may develop around the expander. In some cases, the expander may need to be removed for several months until the infection clears. A new expander can then be inserted.
You may have concerns about the use of a silicone tissue expander in this procedure because of the Food & Drug Administration’s (FDA) limitations on silicone breast implants. At this time, the FDA ruling does not affect tissue expanders because they are filled with salt water, not silicone gel, and not permanent placements.
During your initial consultation, your surgeon will evaluate your condition. Your age, skin condition, medical history and other factors will help your surgeon determine if you will benefit from tissue expansion. Your flexibility and tolerance for the inconvenience associated with this procedure will help you decide whether it is right for you.
Your surgeon will give you specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, and medications. If you smoke, your surgeon will probably ask you to quit for at least two weeks before and after your surgery, since smoking may have an effect on how well you heal.
Whether your surgery is done on an outpatient or inpatient basis, you should arrange for someone to drive you home after your surgery, and to help you out for a day or two, if needed.
Tissue expansion is now often performed on an outpatient basis under local anesthesia. Your individual circumstances will determine where the surgery is performed and what type of anesthesia will be used.
The initial operation will most likely take 1-2 hours, depending on the size and area of skin being expanded. A small, discreet incision is made next to the area of skin.
A silicone balloon expander is inserted in 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. Once in place, the expander is gradually filled with salt water through a tiny valve.
When the incision heals, we will need to inject the expander with additional saline. This will require some follow up office visits. As the expander enlarges, your skin will stretch. This may cause minor discomfort for a couple of hours. Any discomfort you experience may be controlled with pain medication.
The expander is removed when the skin is sufficiently stretched. In breast reconstruction, a permanent implant is then inserted. 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.
After the Surgery
The speed of your recovery depends on the extent of the surgery. For breast reconstruction patients, normal activity can usually resume in 2-4 days. Most patients can resume normal activity within a week following the second surgery.
As with any cosmetic surgery, realistic expectations are important. Patients in good physical and psychological health will benefit from this procedure the most.