Tissue Expansion for the Rib Graft Surgical Technique
Tissue expansion is a technique used to increase the area of skin so that more of it can be created and then utilized for skin grafting during surgery. Tissue expansion has been around since before the 1970’s. Tissue expansion involves a balloon being installed into the mastoid section (temporal area just behind the ear) of the skin and then being injected slowly with a saline solution while slowly expanding the area of skin over time so that more skin is created. Usually between 60-80cc or about 3oz of saline solution in total is used to inflate the balloon over a 2 month period. There is a small needle like port that protrudes from the balloon where the saline is slowly injected with a needle. The mastoid skin is more pink in color and matches the color ear skin. There is also minimal scaring.
China is known for expertise in tissue expansion when considering Rib Graft ear reconstructive surgery. Dr. Jiang Haiyue is among the very best surgeons who has successfully mastered tissue expansion. Over 7,000 successful Rib Graft surgeries have been completed using tissue expansion. Tissue expansion is not an easy method and only a skilled surgeon who has experience working with tissue expansion should be considered when considering this option for a skin graft for Rib Graft surgery. The expanded skin can be a little thicker than a typical skin graft and can be more difficult to shrink the skin down around the newly carved Rib Graft framework (during suctioning of the ear when the Rib Graft cartilage is placed in the skin pocket on the head). Also, additional surgeries are required as the balloon first has to be inserted into the mastoid area behind the ear and then the balloon has to be removed. A numbing cream has to be used to help prevent any pain during the injections of saline into the balloon. It is usually suggested that the patient be close to the office during the 2 month period due to multiple office visits to inject the saline. Sometimes, a patient will be allowed to go home where a family member can be trained to inject the saline and send pictures to the surgeon to monitor the tissue area. Although, the skin from the mastoid section is pink in color and tends to match ear skin better. And there is little to no scaring due to utilizing one complete section of skin, the skin is taken from the scalp area and therefore will grow hair. The hair can be removed through laser surgery.
Again, if not seeking the expertise of a surgeon who is specialized in using tissue expansion, it is also possible that the expanded tissue created may die or develop necrosis (dying tissue). The expanded tissue can not be too thick or too think and has to have a good blood supply. It is possible that after covering the Rib Graft ear that the tissue will not survive.
Dr. Jiang Haiyue is a Rib Graft ear reconstructive surgeon who creates beautiful ears with the help of using tissue expansion.
For more information about Dr. Jiang Haiyue and tissue expansion, please visit the following link: www.zhengxing.com.cn/ArticleShowEN.aspx?ArticleID=1696 or contact Dr. Jiang Haiyue at the following address and number:
Plastic Surgery Hospital (Institute) CAMS, PUMC
Badachu Road, Shijingshan District, Beijing, No. 33
Tissue Expansion for the Medpor Surgical Technique
Dr. Sheryl Lewin is also experienced at utilizing tissue expansion, but for Medpor ears. For more information about Dr. Sheryl Lewin and tissue expansion, you may contact her at the below two medical facilities:
Permission to post the following tissue expansion images with Medpor surgery has been granted by Dr. Sheryl Lewin. The patient’s entire ear reconstruction for both left and right ears was covered with expanded skin tissue near each ear. This patient has no scars located anywhere on his body. The skin color match is excellent using the tissue expansion technique since no abdominal or scalp skin was used to cover his Medpor reconstructed ears. A minor second stage revision to improve symmetry will be performed in the future. For more information about Dr. Sheryl Lewin, please contact her at the above two office locations.
If you would like to see additional images of tissue expansion in the skull area and learn more about tissue expansion, you are welcome to visit the following link for more information: http://emedicine.medscape.com/article/880686-overview#aw2aab6b8