[Cutaneous expansion by inflatable implant].

The capacity of the skin to stretch and expand, as shown in pregnancy, has been used by Radovan who, in 1976, introduced skin expanders made of silicone. These are empty balloons of different sizes and shapes which are surgically placed under the skin and gradually filled with saline. The saline solution is introduced through a valve with a syringe and a 21 G needle. Skin expansion usually requires 6 to 8 weeks to be completed. Transient redness of the skin is frequently observed. A thin capsule can be found around the expander but does not need to be removed. The excess skin can be utilized as advancement flap, rotation flap or even two-stage distant flap. Our experience is based on 33 expansions performed in 26 patients (table I). Giant naevi were the most frequent lesions treated (20 cases), and face, scalp and neck were the most frequent localizations (27/33 cases) (table II). Complications occurred in 21 p. 100 of the cases, and 5 expanders had to be removed. Nevertheless, expansion could be completed in most cases, sometimes after replacement of the prosthesis. The results of repair surgery using expanded skin have always been satisfactory: in colour and texture the expanded skin was similar to that of adjacent areas, and sensation was preserved. Skin expansion in fact made it possible to perform local flaps--which usually represent the best solution for skin replacement--by creating hyperlaxity in areas adjacent to the pathological areas. There has been no retraction of the expanded skin, and the scars have shown no tendency to hypertrophic reaction or distension.(ABSTRACT TRUNCATED AT 250 WORDS)