Journal of Aesthetic & Reconstructive Surgery

A Brief History of Tissue Expansion and Lessons from Using a Novel Reverse Tissue Expansion Technique: A Case Review

Background: The tissue expander is made up of an inflatable balloon that is inserted into a pocket of tissue. It undergoes inflation to stretch out the overlying tissue envelope through gradual expansion. We describe a method of using tissue expanders in down-sizing overly augmented breasts through gradual deflation of tissue expanders, in what we call reverse tissue expansion.

Methods: The patient is a 49-year-old woman who had undergone prior bilateral breast augmentation with 1200 cc saline implants. She had associated neck pain and underwent implant exchange to 800 cc implants. She presented to us for consultation as she desired further reduction in implant size due to continued pain. She had a significantly stretched skin envelope and a smaller implant exchange would require a bilateral mastopexy. However, the patient did not want the scars of a mastopexy. We discussed with her a technique of placing tissue expanders with gradual deflation taking advantage of tissue recoiling and subsequent replacement with smaller implants.

Results: Once the expanders were deflated to appropriate size, they were removed and 345 cc silicone implant exchange was performed successfully without need for bilateral mastopexy. Patient was satisfied with the aesthetic results and resolution of her pain.

Conclusion: We describe a unique method of using tissue expanders in a reversal method through gradual deflation. Through this method of utilizing tissue recoiling, we were able to avoid creating additional scarring with mastopexy incisions. To the best of our knowledge, this method has not been previously described and appears worthy to consider in similar situations.

Author(s):

J. Sarah Crowley  and Marek Dobke^*

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