Tissue expansion

 A recent addition to the reconstructive surgeon’s options is tissue expansion. Here, a silicone balloon is placed beneath the planned donor site. The balloon is then inflated by percutaneous injections of saline over several weeks in order to increase the area of the expanded flap. It is then possible at a second operation to remove the silicone balloon and utilise the expanded tissue. Tissue expansion has the advantage of creating large flaps of tissue at sites where this might otherwise be impossible. Where expansion is done adjacent to a defect, the flap will often have ideal properties to reconstruct that defect. It can often be transferred by simple techniques, and sensation can be preserved. Often the donor site can be closed directly if sufficient tissue has been created.