Tissue expansion in the head and neck: current state of the art

Reconstruction of defects following significant facial trauma or ablative surgery for head and neck cancers continues to be a significant challenge to the reconstructive surgeon. A variety of local, regional, and free tissue transfer techniques can be used to affect an outcome that is cosmetically and functionally acceptable. Unfortunately, the quality and quantity of tissue available for extensive facial reconstruction is often limited. The techniques of tissue expansion have been used for many years to expand normal skin adjacent to the site of the defect for use in scalp and facial reconstruction. New applications of tissue expansion in head and neck reconstruction include development of self-expanding implants, use of growth factors and cytokines to improve the outcome of tissue expansion, and application of bone distraction to defects of the midface and mandible.