Prevention of Secondary Depression Deformity after Tissue Expansion

ABSTRACT

Tissue expansion is commonly used method in reconstruction of skin defect after removal of various skin lesions or scars in face, trunk and extremities. However, the expansion pressure not only expands the overlying skin but also compresses the base tissue itself, which may result in depression or asymmetry. Many patients could not be satisfied with these deformities although their skin lesions were removed and reconstructed successfully. Many plastic surgeons have not taken into consideration of these facts. A total of 24 patients underwent 36 implants. The authors tried to fill the depression by manipulating surrounding capsular tissues with elevation of the capsular flap and its transposition to the depressed area, free graft of the resected capsular tissues into the depression. We also used adjacent soft tissues such as fascial flaps to fill the depression and prevented the expected depression deformity or asymmetry after removal of tissue expander. With this method, we achieved satisfactory aesthetic results without depression. There happened 4 cases of remnant depression due to under correction of it and 2 cases of hematoma formation and 1 case of skin necrosis.