title: Advantages of minimally invasive, balloon-dissector-assisted tissue expander placement: a clinical and experimental study.
abstract: BACKGROUND
  Tissue expansion has been dependent upon healing the access incision after placement. Delay can be reduced with minimally placed expanders. Smaller, remote incisions allow for earlier expansion.
  
  
  METHODS
  Balloon-assisted tissue expander placement was evaluated in a pig model and compared with open placement. Open placement with delayed expansion versus minimally invasive placement with immediate expansion, and open placement with immediate expansion versus balloon dissection with delayed expansion were compared. Our clinical series with balloon dissector tissue-expander placement was reviewed. Fifty-two tissue expanders were placed minimally invasively and successfully expanded.
  
  
  RESULTS
  Use of balloon dissector in the pig model yielded a shorter reconstructive period, faster expansion, and greater flap advancement. Clinical results revealed no infections, dehiscence, extrusion, or hematomas. All cases had expansion begun intraoperatively and were successfully expanded.
  
  
  CONCLUSIONS
  Minimally invasively placed expanders resulted in shorter expansion times, the ability to institute immediate expansion, and improved expansion compared with open placement.
authors.affiliation: Department of Plastic, Reconstructive, Oral, and Maxillofacial Surgery, Duke University Medical Center, Durham, NC 27710, USA. sjkovach@hotmail.com
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Kovach
authors.forename: Kim E
authors.initials: KE
authors.lastname: Koger
authors.forename: Bruce
authors.initials: B
authors.lastname: Klitzman
authors.forename: Gunter
authors.initials: G
authors.lastname: Germann
authors.forename: L Scott
authors.initials: LS
authors.lastname: Levin
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D002648:Child; D002675:Child, Preschool; D004724:Endoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D023421:Models, Animal; D019919:Prosthesis Implantation / Q000379:methods*; D012189:Retrospective Studies; D013552:Swine; D015626:Tissue Expansion / Q000379:methods*; D015625:Tissue Expansion Devices