Use of the balloon dissector in minimally invasive aesthetic and reconstructive surgery.

The use of minimally invasive surgery continues to evolve in all fields of surgery with new developments in techniques and instrumentation. One instrument that has evolved and become useful in the field of plastic surgery is the balloon dissector. The purpose of this paper is to examine the role of the balloon dissector in minimally invasive aesthetic and reconstructive plastic surgery. We define the concept of the fascial cleft-the loose areolar space between fascial linings. In addition, the balloon dissector and its use is described. The optical cavity created by the balloon dissector device is discussed, along with the two techniques used to maintain the optical cavity, and manual retraction and carbon dioxide insufflation. The application of the balloon dissector in various regions of the body is discussed along with its use in free tissue transfers. Three patients are presented to illustrate the application of the balloon dissector.