Advantages and Disadvantages of Tissue Expansion

What Is Tissue Expansion?

The body can generate additional skin through a relatively simple process called tissue expansion, which can be used to repair practically any part of the body.

To stretch and grow the skin, a silicone balloon expander is placed under the skin close to the area that has to be healed and slowly inflated with saline or carbon dioxide over time. It is most frequently used for breast reconstruction after breast removal. However, it is also utilized in some aesthetic operations to fix skin that accidents, congenital disabilities, or surgery have injured.

Who Are the Potential Candidates for Tissue Expansion?

Tissue expansion is generally recommended in the following cases

• Breast Reconstruction: Surgery is frequently employed in patients with insufficient skin to accept permanent implantation to recreate a woman's natural appearance.

• Hair Replacement: It can also be used to repair or replace scalp tissue in regions where hair development makes it challenging to use skin from other body parts to replace missing tissue.

• Reconstruction of Skin in Other Body Parts: When reconstructing some parts of the face, neck, hands, arms, and legs, tissue expansion typically yields outstanding results.

The expansion could be more challenging in locations with thick skin, such as the neck, torso, or other body parts. Since good skin is the primary condition, enlargement is likely not an option if the area affected is significantly injured or scarred.

How to Choose a Surgeon?

• Reconstructive surgery is typically carried out by a plastic surgeon.

• Choose a licensed surgeon at all times.

• Ascertain that the surgeon has at least six years of surgical experience and three years of plastic surgery expertise, and that they are a certified member of the American Society of Plastic Surgeons (ASPS).

• A trained plastic surgeon gives the patient results and guaranteed care.

What Are the Preoperative Preparations for Tissue Expansion?

• Before performing the surgery, a plastic surgeon will evaluate the patient.

• Patients' overall health and medical history are checked thoroughly to rule out systemic illness and drug allergies.

• Patients are advised to quit smoking for at least two months.

• Before surgery, patients may be advised to stop blood thinning medications such as Aspirin, Clopidogrel, vitamin E, and Warfarin.

• Patients are advised to take medications prescribed by the doctor.

• Patients can discuss their expectations, risks, and complications associated with the surgery.

• Surgeons may take preoperative photographs to examine the body part to be operated, type of skin, and improve the areas which require treatment.

• Also, preoperative photographs help to evaluate the difference in the appearance of the breasts after the surgery.

• Surgeons will discuss the procedure, type of anesthesia, potential risks, and the outcome of the results.

How Is the Surgical Procedure Done?

Anesthesia:

• This procedure is done under local anesthesia, depending on the size and area of the skin, and patients can go home on the same day.

• The procedure takes one to two hours to complete.

• In some cases, surgeons will choose general anesthesia over local anesthesia.

Procedure:

• First Surgical Procedure: The surgeon makes a pocket under the skin, and surgeon will then put the silicone balloon expander there. The expander has a gas cylinder or self-sealing valve that lets the surgeon fill it slowly with saltwater or carbon dioxide.

• Expander Inflation in the Surgeon's Office: The patients are required to visit the surgeon's office regularly after the wound has healed so that the expander can be inflated. The expander will get bigger, causing the skin to stretch. This technique may cause some discomfort in some people. The expander can be filled with carbon dioxide via a remote dosage controller or by sticking a needle into the self-sealing valve, which may be kept under the skin.

• Second Surgical Procedure: The patient will undergo a second procedure to retrieve the expander and replace the new tissue once the skin has expanded enough to cover the injured area. The process is necessary to eliminate the expander and place the permanent implant during breast reconstruction. This procedure usually takes a few minutes to complete. More lengthy procedures and many expansion sequences may be necessary to finish more complicated surgeries to heal skin on the scalp or face.

What Are the Advantages and Disadvantages of Tissue Expansion?

Until recently, reconstructing injured tissue was only possible through skin folds and grafts. However, tissue expansion offers an additional method with several benefits.

Advantages:

• An almost perfect match of color, texture, and hair-bearing characteristics is provided through expansion.

• There is less chance that the skin will perish because it is still attached to the blood and nerve supply of the donor location.

• Scars are frequently less noticeable because the skin does not need to be shifted from one place to another.

Disadvantages:

• However, skin expansion has a significant negative because adding new skin takes a long time.

• Tissue growth can take three to four months, depending on the region that needs to be rebuilt.

• Throughout this period, the expander can produce an unpleasant bulge that, while desired for breast reconstruction, can be highly obvious for someone who needs their scalp or other body parts repaired.

• Additionally, the treatment necessitates multiple surgical visits to inject saline water that expands the balloon.

• Some people decide against using expanders because of their inconvenience and conspicuous appearance.

What Are the Possible Risks?

Skin growth can result in some fantastic outcomes. However, there are dangers involved with the surgery and particular difficulties involved with this technique, just like with every operation. These include

Risks:

• The silicone expander utilized in the treatment is most frequently worried by breaking or leaking inside the body.

• While expanders are carefully positioned and exhaustively tested, leaks do occasionally occur.

• In the unlikely event that the expander leaks, the saline solution, also known as salt water, that was used to fill it is silently absorbed by the body, and the expander is changed during a brief surgical operation.

• A few patients might experience infection around the expander. Although this could happen at any time, it usually happens a few days after the expander is placed.

Conclusion

Tissue expansion typically produces better results than other techniques for regenerating or repairing injured skin. But remember that progress rather than perfection is the main objective. The method significantly improves the look and quality of life of most tissue expansion patients after surgery.