Forehead Reconstruction with Small Size Tissue Expanders

Tissue expansion is widely accepted as a valuable adjunct for the reconstruction of the forehead lesions. Previous studies often have used the largest possible expander for forehead reconstruction which were often overexpanded. In this article, we describe our experience for reconstruction of the pure forehead lesions covering 25-70% of the forehead surface with small size tissue expanders and advancement flap. 9 patient (mean age 27 years; range 8-47 years) who had pure forehead lesion covering 25-70% of their forehead surface were selected. Rectangular expanders (30cc) were placed subcutaneously in 3 patient and submuscularly in 6 patient, respctively. Two weeks after insertion of tissue expanders, expanders were filled with 45 to 60cc of normal saline during a 5 week period. Advancement flap of forehead were used for all patient. The aesthetic outcome was assessed by looking at symmetry, hairline/brow position and scar appearance. All the after-expansion forehead reconstructions were considered successful. There was no complication such as infection, hematoma, exposure and flap necrosis. Findings of this study suggest that applying small size tissue expanders and advancement flap for reconstruction of pure forehead lesions (with different size and cause) not only have desirable aesthetic consequences, but also reduce the complications and increase the patients’ compliance.