Clinical experience of over-inflation in tissue expansion technique

Abstract

In spite of adhering to a strict methodology that calculates the pre-expansion area for selecting an appropriate implant, the predicted surface area gain after tissue expansion has been completed often falls short of the clinical requirement. Therefore, reaching the desired dimensions of tissue expansion can be achieved by over-inflating the implant even well beyond the vendor’s stated maximum volume. This principle of over-inflating the implant was used in 62 patients using 64 implants from 1983 to 1997 in performing reconstructions in various regions of the body. Three groups were established based on the extent of the over-inflation of the implant (i.e. the first group with fewer than two times, the second group with more than two times and the third group with more than four times the volume). No adverse sequelae due to mechanical failure were attributed to over-inflation but the overall complication rate in our series was 4.8%. For that reason, in our series, over-inflation permits a margin of error in the initial selection of the implant and this permits continued expansion, thus, ensuring a generation of extra tissue for reconstruction.