Tissue
Expansion
Tissue expansion is a procedure that enables the body
to grow extra skin that can be used to reconstruct almost
any part of the body. This procedure stretches the skin
much like a pregnancy stretches a woman’s abdomen.
Although this procedure is used most often for breast
reconstruction, tissue expansion can also be used to
correct birth defects, accidents, and visual deformities
caused by surgical procedures.
The Procedure
The tissue expansion procedure is always performed
in two parts. The first part takes anywhere from 1 to
2 hours. The surgeon will make a small incision in the
skin very near to the skin that is in need of repair.
The skin will be lifted in order to create a pocket.
A silicone bag, or balloon expander, is then placed
inside the pocket under the skin. This expander includes
a tiny tube and a self sealing valve. Sometimes the
tube will stick out from the incision, and other times
it will be directly under the skin.
After the incision is healed, the patient will be allowed
to return home, but will continue regular visits to
the surgeon. Over a period of weeks or months, the silicone
bag will be gradually filled with a saline solution.
As the bag slowly gets larger, the skin will expand
to accommodate it. Once the new skin has grown large
enough, the surgeon can move on to the second part of
the surgery which involves removing the bag and replacing
the old, damaged skin with the newly grown skin.
Will It Hurt?
Patients should only feel mild discomfort from the
balloon expander. Once the incision heals around the
tube, the bag should create no feeling. Some patients
have experienced discomfort during the injection of
saline solution, but it was mild and very temporary;
most of the time, the discomfort only lasted for a few
hours.
Most patients are more uncomfortable with the visual
lump created by the bag rather than the discomfort caused
by it. If repairing damaged skin on the face or head,
patients will have to live with a growing lump for several
months, and some see this as too much of an embarrassment.
When this occurs, surgeons can expand tissue on another
part of the body, but that requires severing the skin
from vessels and nerve endings, which can reduce pigmentation
matches and the skin’s overall acclimation to
the new area.
Risks
Like all procedures, there are some risks that are
associated with tissue expansion. Following the procedure
that involves the insertion of the tissue expansion,
there is a risk of infection and bleeding. If this occurs,
the expander will be removed until the infection is
treated, then the surgery can be tried again.
There is also a risk of the silicone bag leaking. The
bag is filled with a saline solution, so if it leaks,
the solution will be harmlessly absorbed into the body,
however the patient will require another small surgery
to replace the leaking bag.
Results
Every skin cell is involved in microcirculation. When
the skin is replaced, this circulation is disrupted.
Tissue expansion has been one solution to this problem.
By growing skin directly next to the area that needs
to be treated, interrupted circulation can be kept to
a minimum. Tissue expansion aids in reconstruction surgery
by providing local donor tissue that has excellent hair
bearing qualities, texture, and color match with limited
morbidity.
It is important for patients to be realistic. This
procedure can greatly improve the quality of skin in
the treated area, but it might never be perfect. There
is a chance of scarring and even a chance that the new
skin might die. This is the leading surgery for skin
reconstruction and most often produces great results.
By creating smoother, more natural looking areas of
skin, tissue expansion can greatly increase a person’s
stamina and improve one's quality of life.
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