First performed successfully in the late 1970s, tissue expansion has now gained widespread acceptance. It has been adapted by many surgeons to a wide variety of very difficult surgical problems that heretofore were difficult to correct. The
tissue
expansion technique is advantageous in facial reconstruction because it makes it possible to resurface even wider defects with neighboring skin similar in color and texture and superior to skin obtained elsewhere, thereby surpassing conventional
methods.
We used a tissue-expansion technique to achieve soft tissue reconstruction in congenital and acquired defects of various structures of the face since 1986. Rectangular shaped prosthesis with remote internal reservoir was most commonly used types,
and
the expander volume ranged from 1.5 to 1,100ml. Every expander was prefilled to 21 percent of its volume in average and inflation was begun about 2 weeks after implantation. The process was repeated at weekly intervals until adequate tissue
expansion
was obtained. Expansion period ranged from 2 to 31 weeks (mean 13 weeks). Hyperexpansion(mean 130%) was a rule in this series, allowing a skin surplus for reconstruction. Major complication observed in 5 patients included exposure of the expander
in 2
patients, implant failure 1 patient, and infection in 2 patients.
We present our plannings and surgical approaches for reconstruction of various structures of the face using tissue expansion. We also discuss some problems relating to procedural details, some modifications required in each case in accordance
with
the
defect, and some preventive procedures to overcome the complications.
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