Clinical application of tissue-expansion techniques began with the work of Neumann,1 who in 1956 described implantation of an expandable balloon prosthesis beneath the temporal region for reconstruction of an ear. While his work was considered anecdotal, Neumann clearly anticipated the advantages of tissue-expansion techniques. He drew parallels to breast growth, superficial tumors and hernias, and the traditional practices of many societies that expand various anatomic parts for cosmetic purposes. He noted that theoretical advantages of tissue expansion "would include the securing of skin which would be high in quality of match of color and texture with nearby skin, the avoidance of the need for a donor area in the usual sense of the term, and the possible reduction in the number of stages for a particular reconstructive effort."1 In 1957, a dramatic example of "physiologic" tissue expansion of the scalp was described in which a sebaceous cyst at the
Austad ED. Tissue-Expansion Techniques. Arch Dermatol. 1987;123(5):588–589. doi:10.1001/archderm.1987.01660290056015
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