Avoiding Extended Scar in Skin Expansion

Abstract

The principal aim of skin expansion is to provide additional donor tissue without extra donor-site morbidity. Most of the reports about tissue expansion are focused on the properties of expander. Donor-site decision is usually underestimated. Here, we offer to use the defect area and surrounding healthy tissue as the donor site.In 4 cases, expanders were placed just under the defect in a fashion to extend 1 to 2 cm more laterally toward the encircling healthy tissue. The expanded tissue was not mobilized for longer distances; thus, there was no loss in flap gain. The resulting final scar was linear or crescentic. In the Alagoz technique, tissue gain similar in size to the defect is sufficient for reconstruction. The simpler the flap, the best the resulting scar.

Re: “Extensive Defect Reconstruction With Pre-Expanded Anterolateral Thigh Flap”

“…Despite this, we anticipate more patients will turn to ChatGPT as a source of medical information, as it is already deemed among the fastest-growing application in history and its popularity continues to surge. 2 To date, many patients rely on Google as a source of medical information. 3 As such, in previous studies, our group compared ChatGPT and Google responses to commonly asked questions on plastic surgery topics, including breast reconstruction, to evaluate their accuracy.…”

“…The latest ERAS protocols for plastic surgery of the breast recommend that administration of basic analgesics should be started before or during operation and regularly executed after surgery, and opioids should be reserved for rescue analgesia only. 2 As analgesic consumption in the mean hospital stay of 6 to 7 hours before discharge was more than 10 morphine milligram equivalents, we are concerned that an opioid-based protocol without basic analgesics was used for early postoperative pain control in this study. Because postoperative nausea and vomiting is one of the most common opioid-related adverse events, 3 moreover, the use of an opioid-based analgesia protocol should be accounted for increased antiemetic requirements in patients receiving PECS II.…”

Letter to the Editor: Comment on Zilong, et al. The Transfer of Expanded Forehead Superthin Flap Without Frontalis and Less Hair Follicles Pedicled by Superficial Temporal Vessels (Ann Plast Surg. 2023;90:128–132)

“…Placing the expander to the forehead location can be challenging. The reason is that when the expander is placed to the forehead, it covers a large area including the main anatomical structures such as hairline and eyebrow line 5 . These structures may not preserve their anatomical locations during the closure of the donor area.…”

“…The reason is that when the expander is placed to the forehead, it covers a large area including the main anatomical structures such as hairline and eyebrow line. 5 These structures may not preserve their anatomical locations during the closure of the donor area. In your study, it can be easily seen that these significant locations were preserved successfully.…”

A Novel Method for Correction of the Tethered and Contracted Facial Scars: The Three-Dimensional Subcutaneous Z-Plasty

“…Several treatment techniques have been defined such as filler injection, augmentation with de-epithelialized dermal tissues, reconstruction with expander and local, and distant flaps. [3][4][5] The most important disadvantages of these techniques are the lengthening of the scar due to recurrence. Complicated procedures should be performed for the facial area because of the increased aesthetic importance.…”