Tissue expanders of the head and neck: A case series and discussion of lessons learned

Large defects of the head and neck can be reconstructed through multiple mechanisms including skin grafts, local flaps, and free tissue transfer. Tissue expanders offer an adjunct method of reconstruction by improving the versatility of local flaps. A retrospective chart review was performed on patients who received tissue expanders by a single provider at two institutions. Medical records of patients treated with tissue expanders were reviewed for patient demographic variables, information about the tissue expander used, and reconstructive outcomes after tissue expansion. 11 patients were included in this study that had a tissue expander placed between 2014-2022. The age range for this patient population was 2 - 78, and the indication for reconstruction included head and neck cancer, trauma, and keloid scar formation. The reconstruction method for all of these patients was a tissue expander placed with subsequent local flap reconstruction. All 11 of the patients had complete closure of the wound with one patient returning to the OR for wound dehiscence. One tissue expander was removed early due to port extrusion, and one expander was replaced due to early extrusion after placement. Tissue expanders offer many advantages over other reconstruction methods including cosmetic match of surrounding tissue and minimal donor site morbidity. This case series highlights a diverse group of patients and the versatility tissue expanders provide in head and neck reconstruction.