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When new skin is needed for reconstruction, the most common method used is a skin graft or flap. Unfortunately this leaves scars and the new tissue rarely matches the surrounding skin. Tissue expansion describes a method to grow new skin on the patient. In this way it matches the area which is reconstructed. The principle is simple. A special balloon is placed under the skin next to the area where the new tissue is needed. Over several weeks the balloon is gradually blown up until the skin is stretched. This is similar to the skin of a women's abdomen stretching during pregnancy. This provides extra skin and allows reconstruction with tissue which looks like the original.

Tissue expansion is used in several situations including breast reconstruction, hair transplantation and scar revision.


The advantages of tissue expansion are the good match of the skin color and texture, the preservation of feeling and the small number of risks. Tissue expansion appears to produce a net gain in tissue not just thinning and stretching.

The disadvantages of tissue expansion are the prolonged time needed for expansion (sometimes several months), the need for more than one operation and the temporary deformity while the expander is in place. In addition the surgery has the risks of any operation, such as bleeding and infection.


Unfortunately expansion does not work well in scarred skin and in areas like the back where the skin is thick. It produced better results in children or older people, women and caucasians.

Patrick Hudson MD PA, Plastic Surgery

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