Ten-year experience in face and neck unit reconstruction using tissue expanders

Background: Tissue expansion allows optimal aesthetic reconstruction by the use of a similar adjacent tissue to reconstruct a defect without creation of significant donor site morbidity, especially in the face and upper neck area. Methods: A total of 78 patients underwent facial reconstruction by insertion of a tissue expander (TE) in the cheek or the neck due to burn scar, traumatic scar, leschmaniasis or large pigmented nevi. Results: All reconstructions were completed satisfactorily; complications were: complete extrusion (2.6%), incomplete extrusion (3.8%), partial necrosis (14.1%), haematoma (6.4%), wide scar (33.3%), hypertrophic scar (17.9%), lower lid ectropion (1.3%), post-expansion atrophy (2.6%), permanent decrement in sensation (1.3%), sagging (14.1%) and infection (2.6%). Conclusions: The lateral facial areas and neck contain essentially the same type of skin; hence, tissue expansion allows optimal aesthetic reconstruction by the use of a similar adjacent tissue and expanding either the lower face or the neck interchangeably without creation of major donor site morbidity; even when we use free flaps for coverage, although we achieved good contour and sufficient bulk, but due to poor colour match, reconstruction with expanded skin of the upper neck is needed for better result. (C) 2012 Elsevier Ltd and ISBI. All rights reserved.