Nowadays, tissue expansion has become the one of the most popular techniques in the field of plastic surgery since it was first introlduced by Neumann, who attempated an ear reconstruction using a latex balloon with a valve and a connector tube lying outside the skin in 1957 and Radovan, who introduced more safer and controllable soft tissue expansion in 1976.
While the upper leg can be easily expanded, generally we thought a significant complications can be encountered during tissue expansions below the knee area. Cellulitis and tissue compromise frequently occur during expansion in these areas and are thought to be secondary to obstruction of the remaining lymphatics and blood flow in this tight skin area, particularily in case of already compromised lower extremity. Until a recent date, some reconstructive surgerons think the tissue expansion technique is not appropriate to cover the defect below knee area. particularly in the ankle and foot.
From Decomber 1985 to June 1994, authors performed 68 successful soft tissue reconstructions from 61 patients by usage of tissue expansions in the regions below knees. These included 38 cases in legs, 18 cases in ankles and 12 cases in feet. There was no major complication and the detailed surgical technique was described.
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