Versatile use of skin expanders in facial plastic surgery

Large soft-tissue resection defects of the face and scalp present an arduous technical problem for the facial plastic surgeon. Successfully matching tissue coverage with similar skin color and texture is usually limited by the amount of available local skin. Also, the need to limit distortion of fixed anatomic sites when harvesting local skin must be addressed. With the advent and utilization of soft-tissue expanders, the availability of local skin is increased and anatomic distortions are limited. This article describes the versatile use of skin expansion in facial plastic and reconstructive surgery. Expansion techniques include long-term expansion for scalp and cervicofacial defects. Acute intraoperative expansion techniques address repair of perioral, labial, and nasal mucosal lining defects. The success, limitations, and complications of these techniques are reviewed.