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Bid for Surgery: Tissue Expansion
Tissue
Expansion
| Procedure: |
A silicone balloon expander is
inserted under the skin near the area to be repaired and then gradually filled with salt
water over time, causing the skin to stretch and grow. It is most commonly used for breast
reconstruction following breast removal-but it's also used to repair skin damaged by birth
defects, accidents or surgery, and in certain cosmetic procedures. |
| Risk Factor: |
Skin expansion can produce some remarkable
results. But as with any operation, there are risks associated with surgery and specific
complications associated with this procedure. |
| Side Effects: |
A small percentage of patients develop an
infection around the expander. While this may occur at any time, it's most often seen
within a few weeks after the expander is inserted. In some cases, the expander may need to
be removed for several months until the infection clears. A new expander can then be
inserted. |
| Length: |
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| Anesthesia: |
Local |
| In/Out: |
While most tissue expansion is done in an
outpatient surgical facility. |
| Recovery: |
two to four days |
| Duration: |
|
| The Procedure |
Tissue expansion is a relatively straightforward
procedure that enables the body to "grow" extra skin for use in reconstructing
almost any part of the body. A silicone balloon expander is inserted under the skin near
the area to be repaired and then gradually filled with salt water over time, causing the
skin to stretch and grow. It is most commonly used for breast reconstruction following
breast removal-but it's also used to repair skin damaged by birth defects, accidents or
surgery, and in certain cosmetic procedures. |
|
| The best candidates. |
Almost anyone in need of additional skin can
benefit from tissue expansion-from infants to elderly men and women.
The procedure is used widely in breast reconstruction when there is not enough skin to
accommodate a permanent implant to restore a woman's natural appearance. It is also an
option for repairing or replacing areas of the scalp, where hair growth makes it difficult
to replace lost tissue with skin from other areas of the body. Tissue expansion generally
produces excellent results when reconstructing some areas of the face and neck, the hands,
arms, and legs.
Tissue Expansion is ideal for scalp repair
because the stretched skin on the scalp
retains normal hair growth. Most other body
tissue does not grow hair to the same degree.
Following tissue expansion, the repaired
scalp restores a more natural appearance.
Expansion may be more difficult on the back, torso, or other areas where
skin is thick. If the affected area is severely damaged or scarred, expansion is probably
not an option, since healthy skin is the first requirement. |
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| Types of anesthesia |
Your surgeon may use local anesthesia, combined
with a sedative to make you drowsy. You'll be awake but relaxed, and should feel little
discomfort. Or, your surgeon may recommend the use of a general anesthesia, in which case
you'll sleep through the entire operation. |
|
| The surgery |
In most cases, the initial
operation will take one to two hours, depending on the size and area of skin to be
expanded. Your surgeon will begin by making a small incision next to the area of skin to
be repaired, and will do everything possible to make the incision as inconspicuous as
possible.
A silicone balloon expander is inserted
beneath the skin.
He or she will then insert the silicone balloon expander in a pocket
created beneath the skin. The expander includes a tiny tube and a self-sealing valve that
allows the surgeon to gradually fill the expander with saline solution. The valve is
usually left just beneath the surface of the skin.
Once in place, the expander is gradually
filled with salt water through a tiny valve.
Once the incision has healed, you'll be asked to return to your surgeon's
office periodically so that the expander can be injected with additional saline. As the
expander enlarges, your skin will stretch. In some people, this procedure causes some
minor discomfort.
When the tissue has grown to the desired
amount, the expander is removed. In breast
reconstruction, a permanent implant is
then inserted.
When the skin has stretched enough to cover the affected area, you'll have
a second operation to remove the expander and reposition the new tissue. In breast
reconstruction, the surgery required to remove the expander and insert the permanent
implant is relatively brief. More complex surgery to repair skin on the face or scalp will
take longer, and may require more than one expansion sequence to complete. |
|
| Do I have to stay in a
hospital after the surgery? |
While most tissue expansion is done in an
outpatient surgical facility, the size and location of the expansion, as well as the
preference of the patient and surgeon, will dictate where the surgery takes place. |
|
| Risk factors, complications, side effects?
|
Skin expansion can produce some remarkable
results. But as with any operation, there are risks associated with surgery and specific
complications associated with this procedure.
The most common concern is that the silicone expander used in the procedure will break or
leak while it is in the body. While expanders are rigorously tested and placed with care,
leaks do occur. If the expander should leak, the salt-water solution, also known as
saline, used to fill the expander is harmlessly absorbed by your system and the expander
is replaced in a relatively minor surgical procedure.
A small percentage of patients develop an infection around the expander. While this may
occur at any time, it's most often seen within a few weeks after the expander is inserted.
In some cases, the expander may need to be removed for several months until the infection
clears. A new expander can then be inserted. |
|
| How long would recovery take? |
The initial surgery to insert the expander
causes most patients only temporary discomfort which can be controlled with medication
prescribed by your physician.
You may feel some minor discomfort each time saline is injected into the expander, but
this usually lasts only an hour or two. The follow-up procedure to remove the expander and
put the new tissue in place may create some temporary discomfort, but this, too, can be
controlled with medication. |
|
| Would I have a new look? |
Generally, the results of tissue expansion are
superior to other methods used to reconstruct or repair damaged skin. But keep in mind,
the goal is improvement, not perfection. For most tissue expansion patients, the procedure
dramatically improves their appearance and quality of life following surgery.
If you're physically healthy, psychologically stable, and realistic in your expectations,
you'll probably be quite pleased with your new look.
Expansion is also used to repair skin on the
head and neck, hands, arms, and legs.
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Cost of this procedure varies with region from a low of
$*****
to a high of $*****. This cost includes surgeon's fee,
anesthesia, and facility costs. |
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