What Does Scalp Expansion Surgery Involve? (photo)

      The scalp tissue expansion would involve placing 1 or 2 tissue expanders within the scalp in one operation.  Hospital stay is not necessary.  Then, these would be filled and expanded in multiple office visits over the next several months.  Then operation 2 would involve removing the expanders and rotating a scalp flap to cover the defect of the skin graft, which will be excised.  No hospital stay necessary here either.  The main drawback to the surgery is that the scalp expanders are unsightly, and you will want to hide them with a custom hat or bonnet or something. 

Scalp expansion is very effective. The scalp does not stretch as much as one would expect. Therefore, for a large scalp defect that local tissue flaps won't cover a scalp expander is placed under the scalp in a short surgical procedure. This is then sequentially expanded with saline over a period of several months until adequate expansion has been achieved. During the second and final procedure, the expander would be deflated and removed and the skin graft would also be cut out and replaced with the expanded scalp tissue. I hope this information is helpful.Stephen Weber MD, FACS

Your problem is more common than you might think.  Expanding the scalp to take the place of a bald skin grafted area can be done several ways. A small area can be covered by hair bearing scalp by removing small amounts of the skin graft at a time and advancing the hair bearing scalp in increments. This can be done under local or general and has little down time. Usually shaving of hair does not need to be done.  Larger areas can be closed with "scalp flaps".  This can be done in one sitting under general anesthesia.  Again shaving does not need to be done and sutures stay in a week to 10 days.  Areas larger still can be helped by inserting tissue expander(s). This requires  a balloon(expander) under the hair bearing scalp being placed at surgery and adding fluid to it on a regular basis (weekly).  Then when the scalp is stretched adequately the graft is replaced by the expanded scalp at another operation. All of these procedures can be done as an outpatient.