Tissue Expansion: How it Can Help Repair Damaged Skin

What Is Tissue Expansion?

Tissue expansion is a way for doctors to stretch skin so that the body’s own tissue can be used to repair skin-related damage and other conditions; including large birthmarks, scarring from dog bites, car accidents, burns, and infection-related skin loss. It may also be used to stretch nearby skin before a surgery to replace skin that is going to be removed. The procedure is usually done to improve skin appearance because, unlike skin grafts, tissue expansion makes use of healthy skin that is the child’s natural color and texture.

How Is It Performed?

The placement of an expander typically involves an overnight stay, but your child’s doctor may decide that an outpatient surgery is acceptable. The tissue expander, which is a little balloon-like pouch attached to a tube with a port, is placed under a healthy area of skin (usually near the section of skin that will eventually be removed) while your child is anesthetized.

After the initial incision heals, your child will return once a week to have extra sterile saline added to the pouch through the port. Occassionally, parents or caregivers will be taught how to fill the expanders at home. The amount of liquid used to fill the pouch is increased at each visit in order to slowly stretch the skin. Once there is enough new skin, the expander is taken out and the new skin can be pulled over to replace the damaged skin.

What Should My Child Expect After the Procedure?

The expander can stay in place for several months, depending on where on the body the expander is placed, how much damaged skin needs to be replaced and how well your child tolerates the expansion process. While there is a risk of infection as the incision site heals, home care is relatively easy. If your child experiences discomfort you can give acetaminophen or ibuprofen for the pain: follow the directions on the bottle or ask your child’s doctor about dosing.

After the incision has healed, the expander feels like a water balloon under the skin and shouldn’t cause pain. Children with expanders can still be active. Contact sports should be avoided, but many kids can run, swim, dance and bike without limitations.

Older children may find the tissue expander to be a source of questions or teasing, but the scar left by the expansion is often easier to explain and less distracting than the damaged skin was. Your child’s plastic surgery team should be prepared to help your child with every aspect of care including emotional and behavioral health needs.