A Larger Size of the Forehead Expander Can Reduce Donor Site Deformities and Acquire Better Outcomes After Forehead Tissue Expansion.

Background: Both reconstructive outcomes and donor site deformities should be considered in forehead expander selection for resurfacing facial skin defects. Cranial bone deformity as well as bone resorption always cannot be completely normalized after tissue expander extraction. This study aimed to investigate the correlation between the degree of frontal deformity, the reconstruction outcomes, and the expander size.

Patients and methods: Cases of forehead tissue expansion performed from 2011 to 2020 with 50/80 mL sized expanders and 150/200 mL expanders were retrospectively reviewed and separated into 2 groups. Demographic and clinical data were collected. Two plastic surgeons (Y.Z. and L.L.) who were not involved in the operation process compared the patient's preoperative photos with their final follow-up photos. The Fisher exact, 2-sample t tests, and the Wilcoxon rank-sum test were performed in this study.

Results: Ultimately, 51 patients were included in the 50/80ml sized expander group, and 28 patients were included in the 150/200 mL expander group. Demographic data were collected and had no statistically significant differences between the 2 groups. There was no statistical difference in the frontal deformation rate between the 2 groups. The degree of frontal deformation was significantly different, and a large expander could significantly reduce the frontal deformation degree ( P < 0.05) and acquire a higher evaluation of the whole reconstruction outcomes ( P = 0.007).

Conclusions: The large-sized (150/200 mL) expander sited on the forehead was shown to have a slighter postoperative forehead change and better reconstruction effect. It is advisable to choose expanders with relatively larger sizes in the application of the forehead expand flap.