Tissue expanders are silicone devices used to stretch and grow skin, commonly used in breast reconstruction surgery. They require regular saline injections and can cause discomfort. Patients must avoid smoking and certain medications before the procedure and discuss possible risks with their physician.
Tissue expanders are silicone devices used to stretch and grow the skin. They are temporarily inserted under the skin in a relatively simple surgical procedure. Over the next few months, they are gradually expanded through regular saline injections. When the skin has been properly stretched, the tissue expanders are removed.
Breast cancer survivors who have had a mastectomy or breast removal may consider using a tissue expander. Tissue expanders are most commonly used in breast reconstruction surgery. They can also be used in other patients who need new skin, as an alternative to a skin graft. In these cases, the procedure is ideal for repairing the damage to the scalp, because hair will continue to grow in the area.
While this procedure can help patients develop new skin without much scarring, it also has some potential drawbacks. It may take three to four months for the skin to shed. As the tissue expanders grow, it creates a bulge in the skin. This is not often a disadvantage for those undergoing breast reconstruction, however, those with a tissue expander on the scalp or other area may not want this look. Tissue expanders also require frequent doctor visits for saline injections.
Not all patients are ideal candidates for tissue expansion. Those undergoing radiation therapy should wait for the treatment to complete. This is to prevent the implant from hardening. Also, tissue expanders generally cannot be used in areas with severe scarring or damage, as healthy tissue is required for expansion. This procedure may also be more difficult in areas of thicker skin, such as the back or torso.
Preparation for the procedure should include a discussion of the patient’s complete medical history, including allergies, medications, and medical conditions. Patients may need to avoid smoking and certain medications for a period of time before surgery. Also, they should arrange for someone to drive them home following the procedure. The type of anesthesia used depends on the patient’s preference and the doctor’s recommendations.
If the patient is placed under general anesthesia or rendered unconscious, they will need to refrain from eating or drinking for a period of time before the procedure. Alternatively, local anesthesia can be used. This simply numbs a specific area of the body.
The procedure itself can often be done on an outpatient basis, meaning the patient does not stay overnight in the hospital. An exception to this is if the patient has the tissue expander inserted soon after a mastectomy is performed. For the procedure, an incision is made and the tissue expander is inserted. A valve and tube leading to the expander is left just below the skin’s surface.
After the incision heals, the patient goes back to the doctor about every two to three weeks. The doctor injects a saline solution through the valve, which gradually expands the device. This can cause some discomfort for an hour or so afterwards. Once the skin has been sufficiently expanded, the tissue expander is removed. If the procedure is for breast reconstruction, a breast implant is then inserted into the newly created pocket of skin.
Patients considering tissue expansion should discuss possible risks with their physician. It is possible for expanders to leak or break, in which case they will need to be replaced. Patients may also develop an infection, which will require the expander to be removed until the infection is treated and gone.
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