Tissue expansion

Tissue expansion
Intervention
MeSH	D015626
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Tissue expansion is a technique used by plastic and restorative surgeons to cause the body to grow additional skin, bone, or other tissues. Other biological phenomena such as tissue inflammation can also be considered expansion (see tissue inflammation below).

Skin expansion is a common surgical procedure to grow extra skin through controlled mechanical overstretch. It creates skin that matches the color, texture, and thickness of the surrounding tissue, while minimizing scars and risk of rejection.

When skin is stretched beyond its physiological limit, mechanotransduction pathways are activated. This leads to cell growth as well as to the formation of new cells. In some cases, this may be accomplished by the implantation of inflatable balloons under the skin (see figure). By far the most common method, the surgeon inserts the inflatable expander beneath the skin and periodically, over weeks or months, injects a saline solution to slowly stretch the overlaying skin. The growth of tissue is permanent, but will retract to some degree when the expander is removed. Topically applied tissue expansion devices also exist. These have the benefit of being inexpensive and do not require a surgical procedure to implant them under the skin.

Breast reconstruction surgery, for example, can use this technique when the mammary gland was removed by surgery (mastectomy). Later, a more permanent breast implant filled with saline or silicone gel is inserted under the expanded skin pocket.

In other applications, excess skin is grown purposely by expansion on the back or the buttocks, so that it can be harvested later for transplantation to another site where skin was lost due to trauma, extensive wounds, surgery, burns, etc.

Tissue expansion has also been used for the technique of foreskin restoration, which is usually non-surgical and applies tension externally using specialized devices to replace circumcised tissues with new cells.

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