Pediatric Tissue Expansion: Techniques, Considerations, and Complications

Tissue expansion (TE) is a well-established reconstructive technique to grow native skin and soft tissue for the repair of congenital anomalies. Although commonly applied for burn scar contractures and congenital melanocytic nevi, it can be leveraged to treat a variety of conditions. TE functions by means of mechanotransduction to influence gene expression and promote tissue growth. This article explores operative considerations and techniques, such as expander selection, port choice, expansion timing, and region-specific considerations. In addition, complications and adaptive strategies are discussed. When used effectively, TE can be a powerful tool in pediatric reconstruction, enabling surgeons to achieve an enhanced aesthetic outcome that might otherwise be difficult to attain.