Background: The motive of this study was that the results
of some cheek scars revisions may appear to be disappointing
owing to their sites or direction even with much efforts. By
using tissue expanders, the scars repositioning and reorientation
in relation to the cheek unit borders and Resting Skin Tension
Lines (RSTLs) may provide the basis of superior results in
scar revision and management. So, we aim to demonstrate
the effect of cheek skin expansion by tissue expanders on scar
repositioning and reorientation to achieve a superior aesthetic
outcome.
Methods: This prospective study was conducted on 13
patients with obvious linear (8 cases) or irregular (5 cases)
cheek scars who were willing to move these scars to less
conspicuous sites. We used rectangular tissue expanders in
all cases with (40 to 200ml.) capacity. They were selected
suitable to be inserted under the donor tissue and generate
the proposed expansion required for scar repositioning.
Results: The concept of complete moving the scar outside
the cheek unit (optimal revision) has been applicable to 5 in
13 patients (38.5%). However, suboptimal revision has been
applicable in the form of scar reorientation typically in RSTLs
succeeded in 5 of 13 patients (38.5%) or repositioning the
scar outside the malar region in one case (7.7%). Partial
revision in the form of incomplete scar resection occurred in
1 case (7.7 %). Only in one case (7.7%), the expansion was
aborted due to early wound dehiscence (failure). In 10 out of
13 tissue expansion cases (77%) were achieved without
complications. At the same time, one minor complication has
occurred in one patient i.e. hematoma (7.7%). Major complications
have occurred in 2 cases i.e. expanders were exposed
(15.4%).
Conclusion: Facial tissue expander usage in repositioning
and revision of linear and irregular cheek scar is a