Tissue Expansion Used from Treating a Potentially Deadly Defect to Reconstructing Breasts

George Humphrey
March 27, 2001

A baby is born healthy with 10 fingers and 10 toes and a mole covering half his body. This rare condition is known as giant congenital nevus, and while not immediately fatal, the condition puts the baby at high risk for malignant melanoma.

In the past, surgeons were limited to skin flaps and skin grafts to remove nevus tissue and to replace it with normal tissue. Today, doctors are using tissue expanders.

"Tissue expansion enables the body to 'grow' extra skin for use in reconstructing almost any part of the body," explains Kian J. Samimi, assistant professor and section chief of Plastic/Reconstructive Surgery at the University of Arizona College of Medicine. A balloon 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. Once the normal skin is stretched enough to cover the affected area, a section of the nevus tissue is removed and the new skin is used to cover the wound.

Tissue expansion has several advantages, Dr. Samimi says. First, expansion offers a near-perfect match of color, texture and hair-bearing qualities. Second, because the skin remains connected to the donor area's blood and nerve supply, there is a smaller risk that it will die. In addition, because the skin doesn't have to be moved from one area to another, scars are often less apparent.

Tissue expanders also have been used in breast reconstruction with excellent results, Dr. Samimi adds. The balloon expander can be placed immediately following a mastectomy. After the skin over the breast area has stretched enough, the expander may be removed and a more permanent implant is inserted.

Almost anyone in need of additional skin can benefit from tissue expansion -- from infants to the elderly, Dr. Samimi says.

"It can be used to replace disfiguring scars on burn patients, and 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," he says.




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