Tissue Expansion Surgery

What is Tissue Expansion?

Tissue Expansion is a procedure performed to promote the growth of healthy supplementary skin used for the replacement of damaged skin. This reconstructive procedure is an option for almost any area of the body, allowing plastic surgeons to repair skin damaged by both congenital and acquired defects. Excellent results are commonly attained when performing tissue expansion to regions of the face, neck, arms, hands, and legs. Sections where the skin thickness is greater, such as the back and torso, prove to be more difficult to expand. In areas where the skin is severely damaged or scarred expansion is usually not an option since healthy skin is the primary requirement.

Who is a good candidate for Tissue Expansion?

First and foremost, you must be in good health, have no active diseases or serious, pre-existing medical conditions, and you must have realistic expectations of the outcome of your surgery. Excellent results are commonly attained when performing tissue expansion to regions of the face, neck, arms, hands, and legs. Sections where the skin thickness is greater, such as the back and torso, prove to be more difficult to expand. In areas where the skin is severely damaged or scarred expansion is usually not an option since healthy skin is the primary requirement.

NOTE: If you smoke, recently quit smoking or have been unable to stop completely, or you are exposed to second-hand smoke, you may not be a candidate for surgery. Primary and secondary smoking decreases blood supply to the body's tissues, resulting in prolonged wound healing, skin loss, infection, increased scarring, and a number of other complications related to the kind of procedure performed. Click here for more information related to smoking and wound healing.

How is the procedure performed?

Tissue expansion is accomplished by placing a balloon like expander underneath the skin adjacent to the damaged region. Over a period of time, the expander is filled with saline solution causing the skin around it to grow and stretch. Once the new skin has reached it's ideal size the tissue expander is removed and the new skin is redistributed, replacing the damaged area of skin. The primary advantages to using this reconstructive method as apposed to skin flaps or skin grafts is the near - perfect match of color, texture and hair bearing qualities attained. There is also a smaller risk that the skin will die, because the skin remains connected to the donor area's blood and nerve supply. Furthermore, scars are often less apparent due to the fact that skin doesn't have to be moved from one area to another.

List of Physicians Who Perform Tissue Expansion

For details about education, experience, and specialty in this clinical area, please visit these physician profile pages:

• Amy K. Alderman, M.D.
• David L. Brown, M.D.
• Paul Cederna, M.D.

Planning for Your Surgery

The first step is to schedule a personal consultation with your plastic surgeon. Communication is crucial in reaching your goals. You will have the opportunity to express your goals and the results you'd like to achieve. Together, you and your surgeon will reach an understanding about what you can expect from this procedure and the long-term benefits you will experience. Every patient is different, and your surgeon will choose the surgical technique and treatment plan that is right for you. During the initial consultation, you should expect:

• To provide a complete medical history, including information about previous surgical procedures; past and present medical conditions; and any medications or herbal supplements you are taking.
• Your surgeon to conduct a complete physical examination.
• To have measurements and photographs taken for your medical record.
• To discuss possible risks and complications of the procedure.

Preparing for Your Surgery

You will be given a pre-operative information packet that explains everything you should do and know before your surgery date. Your surgeon will give you specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins and medications. 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 after you leave the hospital, if needed.

Where Your Surgery Will be Performed

Your procedure will take place at the University of Michigan Hospitals which provides state-of-the-art surgical suites and recovery areas. The majority of these procedures are completed on an out-patient basis.

Types of Anesthesia

You'll remain comfortable throughout the entire procedure. In most cases, general anesthetic is used so that you will sleep throughout the procedure; although local anesthesia with intravenous sedation is also an option for some patients.

After Your Surgery

Click here for information about how to care for yourself after the surgery and what to expect during your recovery. It is very important that you follow your surgeon's instructions in order to promote healing and progress towards your new physical appearance. Also, it is important that you attend all follow-up appointments scheduled so that your surgeon can assess your long-term results and answer any questions or concerns you may have.