You may not have heard of tissue expansion, but Dr. Hetzler uses this procedure to “grow” extra skin for later use in reconstructing most any part of the body. The procedure is common in cases of breast reconstruction but can be used elsewhere, as well.
What is tissue expansion?
In this procedure, Dr. Hetzler inserts a silicone balloon expander under the skin near the area to be repaired. This balloon is gradually filled with salt water over time. As the balloon is slowly expanded over months, the skin above stretches and grows. In addition to breast reconstruction, tissue expansion can be used to repair skin damaged by birth defects, accidents, or surgery.
For breast reconstruction, tissue expansion is used when there is not enough skin to accommodate a permanent implant to rebuild a woman’s breast after mastectomy. It can also be used on the scalp after an accident or when an area of skin is removed due to skin cancer. Tissue expansion works well on the face, neck, hands, arms, and legs. It is less effective on areas such as the back and torso where the skin is thicker.
Compared to skin flaps and grafts
In the past, in cases where the additional skin has been needed, surgeons such as Dr. Hetzler were limited to using skin flaps and skin grafts to reconstruct damaged tissue. Tissue expansion has several advantages.
First, tissue expansion, because it grows in the exact area needed, provides a near-perfect match of color, texture, and hair-growing qualities. Plus, unlike grafts where the skin sometimes dies after placement, because tissue expansion skin remains connected to the patient’s blood and nerve supply there is a much smaller risk the new skin will die. Finally, because the skin doesn’t have to be moved from one area to another, there is far less scarring.
A drawback is a time necessary for tissue expansion. The balloon is filled gradually, allowing the skin to stretch and recover. This takes as long as three to four months. While this isn’t a problem in the breast area, where rebuilding a breast is the desired end, it can be unsightly in other areas such as the arm or head.
The second surgery
There is a first surgery to place the balloon expander. This is placed in a pocket created by Dr. Hetzler beneath the skin. The expander includes a tiny tube and a self-sealing valve that allows Dr. Hetzler to gradually fill the expander with saline solution.
Once the skin has stretched enough to cover the affected area, the patient returns and has a second surgery to remove the expander and to reposition the new tissue.
Dr. Hetzler has extensive experience with reconstruction surgeries. If you have the need for additional skin for breast reconstruction or other reasons, trust his expertise. Call us, 732-219-0447, to schedule a consultation.