Checking Back with Zac: What is a Tissue Expander anyway??

It is slowly setting in now that only the surgical part of this journey is over. As hard as that was, it was only phase I of this process. The next phase will be filling Zachary's expanders mostly every week. Let me tell you a little bit about tissue expanders. Like the skin in pregnancy, we know that skin has the ability to stretch to accommodate growth beneath it. A tissue expander works pretty much just like this (think deflated balloon). There are various shapes and sizes of expanders based on the dimension of what they refer to as the 'donor site' which is basically the area where you want to 'grow' the good skin. These expanders are amazing. They are used to treat not only congenital nevus but also burns, scars and Alopecia (absence of hair from skin areas where it is normally present). I have had many people ask about skin grafting which can also be done but here are some advantages of tissue expansion.

Good color match - different areas of the body have different pigments, texture, etc.
Normal sensation - the expanded area develops its own blood and nerve supply, therefore the patient will feel sensation to the touch.
Minimal donor morbidity - when skin or tissue is grafted sometimes rejection can occur.
Decreased hospitalization - with skin grafting there is a higher risk of infection, it is more painful and the patient often needs to be immobilized.

After the expander is placed under the donor site, a 'port' is also placed under the skin. The port is where the saline will be injected weekly. The expander that Zachary has in his shoulder/underarm is capable of holding 500cc of saline. Next Monday, we will go into Dr. Bauer's office for Zac's first 'fill' and will learn to do it ourselves. I have to admit, the idea of it makes me just about crawl out of my skin. So, not only did I just put my kid through the pain and risk of surgery, but now I get to poke and disfigure him even more...weekly....great! Sounds like fun....ugh. From what I hear, Lidocaine topical cream is put onto the port about an hour before injection to help numb the spot....but still...no fun.

So, this is the source of my anxiety this week although Zac is getting happier day by day. We may even be able to explore some of the more touristy things that Chicago has to enjoy (as long as they are cheap LOL and as long as I can kick this cold I have developed). Last night we got to meet up with the Vance's and the Melton's at the Rainforest Cafe for the Melton's last night in Chicago. Little Joshua had his first expansion yesterday and they are good and ready to get home to Arizona.