Tissue Expansion — SCE Dermatology MCQ
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Correct answer: D — A silicone balloon expander is placed subcutaneously adjacent to the naevus and gradually inflated over weeks, generating extra skin that can then be advanced to close the defect after naevus excision
Tissue expansion involves placing a silicone balloon expander subcutaneously adjacent to the lesion requiring excision. Over 8-12 weeks, the expander is gradually inflated with saline via a subcutaneous port, mechanically stimulating the skin to grow additional tissue (biological creep and mechanical creep). Once sufficient extra skin is generated, the expander is removed and the naevus excised, with the expanded skin advanced to close the defect. Advantages: colour/texture match (using adjacent native skin), reduced need for grafts, and larger defect closure. Disadvantages: multiple procedures, temporary disfigurement during expansion, infection risk, and expander exposure/failure. It is particularly useful for large congenital naevi in children.
Reference: BAD; Paediatric Plastic Surgery