When it comes to reconstructive or cosmetic surgery, it’s always good to have options. And in many cases, tissue expansion can do what skin grafts and skin flaps cannot. This process of growing extra skin or tissue so surgeons can reconstruct certain parts of the body will often yield “remarkable results,” in the words of the American Society of Plastic Surgeons.
Most commonly used for breast reconstruction and scalp repair, tissue expansion can also be used to rectify scars or skin damage from large birthmarks, accidents, burns, infections, animal bites, and even other surgical procedures. Because tissue expansion makes use of healthy skin near the area being reconstructed, and there’s no need to move the skin from one area of the body to the other, the skin matches the reconstructed area in skin tone and texture. The skin remains connected to the same blood and nerve supply throughout the process. There’s less scarring than what you would see with a skin graft or flap, so the final results often look far better. Additionally, tissue expansion on the scalp yields skin that is able to naturally grow hair.
Tissue expansion is achieved by inserting a silicone balloon beneath the skin near the affected area. The surgeon then inserts a needle into the balloon’s self-sealing valve and fills the balloon with a saline, or saltwater, solution. As the balloon expands, the skin stretches. Over the course of several appointments, sometimes for three to four months, the balloon gets refilled until the bulge in the skin is large enough to provide sufficient tissue for reconstruction.
While tissue expansion yields excellent results, it’s not without its drawbacks. The need for frequent appointments to refill the balloon can be time consuming, particularly if it must go on for months at a time. Furthermore, tissue expansion isn’t always inconspicuous. Although patients undergoing tissue expansion for breast reconstruction can hide the growing bulge under clothing, a scalp reconstruction patient might feel self-conscious about having the bulge grow on the top of their head.
The American Society of Plastic Surgery also emphasizes that tissue expansion is about “improvement, not perfection.” While the results will be better than what patients would see with other procedures, it’s important to have realistic expectation. Those who do will often feel much more attractive and confident thanks to the new look this cosmetic procedure has given them.