Background: The use of the balloon dissector ("space maker") for the implantation of soft tissue expanders is illustrated and technical aspects and advantages are compared to the conventional method.
Patients and methods: Over a 10-year period a group of 90 patients with evaluation records (m = 34, f = 56) was analysed retrospectively. The mean age was 23 years (range: 5 to 62 years). Overall, 164 expanders were implanted and in 73 cases (44.5%) a balloon dissector was used.
Results: The mean intraoperative expander filling was increased up to 27% of the volume of the tissue expander after using the balloon dissector; in contrast it was 15% after conventional dissection. The mean duration of expansion was decreased by 9.8% after space maker dissection.
Conclusion: The use of the space maker is a scar-sparing technique. Time of operation and overall duration of expansion are reduced. Patient comfort is clearly improved. The negligible costs of a space maker are compensated by the cost reduction due to shorter operating time, fewer outpatient contacts and a low complication rate. The indications for the use of balloon dissectors are the expansion of skin (scar correction after burns, trauma, tumour), breast reconstruction and augmentation, and the prefabrication and rapid intraoperative expansion of musculocutaneous flaps.