The concept of tissue expansion by the placement of inflatable subcutaneous
silicone implants was popularised by Radovan in the late 1970s and is now
widely used in clinical practice. After the initial placement of the expand
er, a series of outpatient visits is required during which the expander is
serially inflated. These visits can be very stressful for the patient and a
re costly in terms of patient transport and clinic time. We present a serie
s of 26 expanders (in eight patients) that were inflated at home by the pat
ient or a relative, and compare the results with those from 30 expanders (i
n 15 patients) inflated in the outpatient department. The results show that
whilst there was a slightly higher incidence of minor infections in the gr
oup inflated at home (42% versus 23%, P > 0.05), the overall success rate o
f the operation was greater in the home-inflation group (96% versus 90%, P
> 0.05). However, these differences were not statistically significant. Thi
s study provides evidence to support the practice of inflation at home, whi
ch is safe, cost effective and less stressful for the patient. (C) 2001 The
British Association of Plastic Surgeons.