The use of tissue expanders in head and neck surgery has been populari
zed since the early 1980s. Tissue expanders are currently used in nasa
l reconstruction, alopecia, and other head and neck defects when there
is inadequate tissue or when transposition of a local flap would crea
te a significant donor-site deformity. Occasionally, situations in hea
d and neck reconstruction arise where local, regional, or free flaps a
re not available or sufficient for head and neck reconstruction. In th
ese situations, the use of controlled tissue expansion can be employed
for enlarging myocutaneous flaps for head and neck reconstructive sur
gery. Two cases illustrated here present the principles and techniques
of this means of reconstruction.