The application of tissue expansion in children has allowed the plastic surgeon to achieve functional and aesthetic goals that were previously unobtainable. In our study we inserted 25 expanders for treating 18 patients their ages ranged between 2 and 13 years. Expanders were classified according to the site of valve (internal or external) new or reused. Complication were classified into major and minor, we concluded that certain precautions should be considered to decrease the incidence of complications by careful patient and parents selection, proper planning of incision and implant place, creation of adequate pocket for expander insertion, the use of internal valve whenever possible.