Tissue Expansion

Tissue expansion refers to a surgical procedure conducted to promote skin growth for purposes of reconstructing a specific part of your body. The procedure is facilitated by a silicone balloon which is implanted under the patient’s skin next to the region that is being treated. The silicone balloon is progressively filled with salt water to enable the skin grow overtime. While tissue expansion is mostly associated with breast reconstruction, this treatment can be used for special cosmetic procedures. It can also be used for repairing skin damage resulting from various factors including accidents, surgery, and birth defects.

The Best Candidates for Tissue Expansion

Tissue expansion is ideal for anyone who requires additional skin. Therefore, anyone can undergo this procedure regardless of their age.

This treatment is popular in breast reconstructive surgery. During this procedure, it is crucial for the patient to have sufficient skin to hold the permanent implant that restores their natural appearance. When the patient who is undergoing breast surgery does not have ample skin for the implant, a skin expansion procedure is necessary.

When replacing or repairing parts of a patient’s scalp, the issue of hair growth makes it preferable to use tissue expansion to replace lost tissue than to use skin from other parts of the body. Tissue expansion also generates an impressive outcome when used to reconstruct parts of the face, neck, arms, hands, and legs.

Skin expansion procedures are difficult when used on body parts with thick skin such as the torso and back. If such regions are extensively scarred or damaged, expansion may not be a viable option because the basic requirement is to use healthy skin.

Advantages and Disadvantages of Tissue Expansion

In the past, surgeons relied on skin grafts and skin flaps for repairing damaged tissue. Modern medicine now utilizes tissue expansion for reconstruction of damaged tissue. This procedure comes with numerous advantages over the conventional skin repair techniques.

One of the upsides of skin expansion is that you get a close match of texture, color, and hair- growth qualities. Another admirable benefit of expansion is that the skin is still connected to its supply of blood and nerves. As a result, there is a low chance of skin death or scarring. With grafting, skin has to be disconnected from its blood and nerve supply and fixed to another part of the body. This procedure poses a high risk of skin death and scarring.

One of the drawbacks of expansion is the duration of time it takes for additional skin to grow. While the time it takes to grow skin will depend on the area being treated, expansion typically takes between 3-4 months.

Apart from the procedure taking a long time to be concluded, the expander that is inserted in patients usually creates an unsightly swelling. This bulge may be desirable in cases of breast reconstruction but it is quite visible for patients who have undergone scalp repair or the reconstruction of other parts of their body.

The other downside of expansion is the numerous visits one has to make to the surgeon to receive salt water injections for inflating the balloon. Many people opt out of an expansion procedure due to the inconvenience of repeated doctor appointments and also because of the visibility of a bulging expander.

All Surgery Carries Some Uncertainty and Risk

Although skin expansion produces great results, like any surgical procedure, they are likely to be risks and complications. Read more about this here: https://www.leonardplasticsurgery.com/?project=tissue-expansion%20

The major concern with this procedure is the breaking or leaking of the silicone expander. Expanders are thoroughly tested and inserted with utmost care but they do tend to leak. When an expander leaks, the saline (salt-water solution) is absorbed by the patient system without causing any harm. In such cases, a small surgical procedure is conducted to replace the expander.

Very few patients have reported infections near the area where the expander is placed. Though this has been known to occur, it happens a few weeks following the placement of the expander. When a patient suffers from such an infection, the expander may be removed for a couple of months to allow the infection to clear. Afterwards, a new expander is inserted in its place.

Planning Your Surgery

During your first consultation, Dr. Leonard will examine your condition. Dr. Leonard factors your age, medical history, skin condition, and many other related factors when determining whether you are fit for the procedure. You will also need to determine whether you can bear the inconvenience that this procedure will cause you. Before you decide to go ahead with skin expansion, discuss with Dr. Leonard about your understanding of the procedure.

Preparing For Your Surgery

Before Dr. Leonard operates on you, he will instruct you on how to brace yourself for surgery. Dr. Leonard will give you guidelines about what diet to take, smoking, and steering clear from certain medications.

Smoking can greatly affect the healing process of surgical procedures. If you are a smoker, Dr. Leonard will instruct you to stop for at least 2 weeks prior to and after surgery.

Regardless of whether your procedure is inpatient or outpatient based, it is advisable to arrange for a person to take you home afterwards, and to assist you with basic chores for a couple of days.

Where Your Surgery Will Be Performed

In most cases, tissue expansion is performed in outpatient facilities. However, the main determinants of where your surgery will be performed are the location and size of the skin expansion. The preference of the surgeon and patient also help determine where the procedure is conducted. Read more here: https://docs.google.com/document/d/1Yk4qonEucuqZAl7P4a2pZjDKTtKKtXtilegKiYxIwBI/edit?usp=sharing

During breast surgery, Dr. Leonard may opt to commence the expansion procedure immediately. However, if are suffering from an injury, Dr. Leonard may advice you to wait until the wound heals before performing the procedure at an outpatient facility.

Generally, most surgeons perform expansions in outpatient centers due to convenience and the huge cost savings.

Types of Anesthesia

Leonard will most probably use anesthesia and a sedative before he starts operating on you. You will feel relaxed and might experience a little discomfort. Alternatively, Dr. Leonard may use general anesthesia to make you sleep throughout the operation.

The Surgery

Dr. Leonard will start by making a tiny incision near the part of the skin that is being enlarged. He will then fit in a silicone balloon expander beneath your skin. The balloon expander has a small tube and a valve through which the surgeon will pour in a salt-water solution. The valve remains below the surface of your skin.

After your incision heals, Dr. Leonard will ask you to return to his office so he can refill your expander with saline. Your skin stretches in relation to the expansion of the silicon balloon, a process that is a bit uncomfortable for some patients.

When your skin has stretched far enough, you will undergo a second surgical procedure. During this procedure, Dr. Leonard will extract the expander and re-position the newly formed tissue. The time it takes to conduct this surgery depends on the area the surgeon is operating on. For breast surgery, this second procedure is brief. In expansion procedures for the scalp or face, the extraction process is far more lengthy and complicated.

After Your Surgery

The way you feel after the procedure usually depends on the complexity and extent of the surgery. Many patients report minor discomfort after the first surgery. Dr. Leonard will prescribe some medication to relieve such temporary discomfort. You may also experience minor unease whenever the surgeon injects saline into the silicone balloon. This discomfort only lasts a little while.

The final procedure of removing the expander and repositioning the new tissue may also cause minor discomfort. Dr. Leonard will prescribe medication to ease this discomfort as well.

Getting Back to Normal

The period it takes to go back to your regular routine will depend on the type, complexity, and length of the surgery. If you have undergone breast reconstruction where the expansion was conducted as a separate procedure from the breast removal, you can expect to be up and running in four days at most.

Many patients who have undergone tissue expansion are unable to resume their regular routine when the expander is still implanted. However, after the extraction surgery, many patients are fit enough to go back to their normal life in a week’s time.

Your New Look

When compared to conventional surgeries like skin grafts and flaps, tissue expansion has proven to be better in numerous ways. Expansion produces superior results that traditional techniques cannot achieve. When signing up for an expansion procedure, you should be realistic and avoid expecting miraculous results. Like any surgical procedures, an expansion is meant to improve and not to perfect. Therefore, you should be aware of the limits and the risks of this procedure. Many patients of an expansion procedure experience an improved appearance and a better quality of life after surgery. Provided you are physically healthy, mentally stable, and have realistic expectations, you will be impressed by the results of a tissue expansion.

Contact Leonard Plastic Surgery

Leonard Plastic Surgery

Water Place │ 500 Liberty Street S.E., Suite 400 │ Salem, OR 97301

(503) 391-2760 │leonardplasticsurgery@gmail.com