Role of tissue expansion in hair restorative surgery

Authors

  • Muhammad Ahmad
  • Humayun Mohmand

Keywords:

Hair restoration, burn scar, tissue expansion

Abstract

Objectives To share the experience of tissue expansion used in hair restoration. Materials and methods The study was carried out from June 2005 to June 2010. In the 1st stage, tissue expander was laced under the normal skin adjacent to the defect. Serial expansions were performed twice weekly. In the 2nd stage, the tissue expander was removed, the defect was excised and adjacent flaps were used to reconstruct the defect. The patients were followed up regularly. Results A total of 16 patients underwent reconstruction with a male to female ratio of 2.2:1. Postburn scar was the most frequent cause (43.8%). The mean expansion time was 33.6 days with average fill volume of 193.4ml. Conclusion Tissue expansion is a safer technique and should be used as a primary procedure prior to hair transplantation in patients with large scalp defects. 

References

Neumann C. The expansion of an area of skin by progressive distension of a subcutaneous balloon. J Plast Surg. 1957;19:124-6.

Ahmad M. Tissue expansion; in reconstructive surgery. Professional Med J. 2011;14:611-15.

Manders EK. Reconstruction using soft tissue expansion. In: Achauer BM, Erickson E, Guyuron B et al., eds. Plastic Surgery: Indications, Operations, and Outcomes. Philadelphia: Mosby; 2000. P. 201-35.

McCauley RL. Tissue expansion reconstruction of the scalp. Seminars Plast Surg. 2005;19:143-52.

Epstein JS. The role of tissue expansion in hair transplant surgery: Presentation of two unique cases. Hair Transpl Forum Intl. 2002;12:108-9.

Epstein JS. Scalp reconstruction: the role of tissue expansion. Hair Transpl Forum Intl. 2006;16:171-2.

Juri J, Juri C. The Juri flap. Facial Plast Surg. 1985;2:269-82.

Unger MG. Scalp reductions. Facial Plast Surg. 1985;2:253-8.

Leedy JE, Janis JE, Rohrich RJ. Reconstruction of acquired scalp defects: an algorithmic approach. Plast Reconstr Surg. 2005;116:54e-72e.

Ahmad M, Mohmand MH. Tissue expansion and hair restoration. Hair Transpl Forum Intl. 2013;23.

Elkafarawi HY, Goma’a RM, Aboueldahab AK. Minimizing the complications in hair restoration by tissue expansion for paediatric post-cicatricial alopecia. Egypt J Plast Reconstr Surg. 2013;37(1):97-100.

Bilkay U, Kerem H, Ozek C et al. Alopecia treatment with scalp expansion: some surgical fine points and a simple modification to improve the results. J Craniofac Surg. 2004;15:758-65.

Lantier L, Martin GN, Wechsler J. Vascular endothelial growth factor expression in expanded tissue: a possible mechanism of angiogenesis in tissue expansion. J Plast Surg. 1998;101:392-95.

De Agustin JC, Morris SF, Zuker RM. Tissue expansion in pediatric burn reconstruction. J Burn Care Rehabil. 1993;14:43-50.

Kolasinski J, Kolendra M. Algorithm of hair restoration surgery in children. Plast Reconstr Surg. 2003;112:412-22.

Barrera A. The use of micrografts and minigrafts in the aesthetic reconstruction of the face and scalp. Plast Reconstr Surg. 2003;112:883-90.

Marzola M. Alopecia reduction. In: Unger WP, Shapiro R, Unger M, Unger R, eds. Hair Transplantation, 5th ed. London: Informa Healthcare; 2010: 483-504.

Qing Y, Cen Y, Liu Y. Prevention and treatment of postoperative complication after skin soft tissue expansion for scar alopecia. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2006;20:1193-95. Chinese.

Saleh Y. Scalp reconstruction using tissue expander. Egypt J Plast Reconstr Surg. 2004;28:71-5.

Zellweger G, Kunzi W. Tissue expanders in reconstruction of burn sequelae. Ann Plast Surg. 1991;26:380-8.

Fan JC, Wang JP. Plastic surgical management of large cicatrical scalp alopecia. Zhonghua Yi Xue Za Zhi. 2009;89: 1098-1101. Chinese.

El Sadat AM. Endoscopic approach for tissue expansion for different cosmetic lesions in pediatric age. Ann Pediatr Surg. 2010;6:27-33.

Downloads

Published

2016-12-16

Issue

Section

Original Articles