Method for surgical dissection, sizing and expansion

Abstract

A method for surgical dissection, sizing and for expansion of a tissue pocket in a naturally occurring fascial cleft is disclosed for use in plastic surgery applications and other applications where it is desirable to dissect an anatomically defined and bounded tissue pocket, determine the appropriate size of a prosthesis to be implanted into the tissue pocket and, if necessary, further expand the tissue overlying the tissue pocket. An inflatable device which performs the three distinct functions of dissection, sizing and tissue expansion is used. In a preferred method, a dissecting balloon device is tunneled bluntly to a desired location within a fascial cleft in the female breast. The device is then inflated to dissect tissue layers adjacent the fascial cleft until ligaments defining boundaries of the fascial cleft are reached, to create a tissue pocket extending to the ligmentous boundaries. After dissection, the tissue pocket may be sized by withdrawing/adjusting fluid from the inflatable member until the desired aesthetic appearance is achieved. If immediate or traditional tissue expansion is desired, the inflatable member may be utilized as a tissue expander and temporarily left in place to provide gradual tissue expansion. After the desired dissection, sizing and optional expanding, an implant prosthesis may be inserted into the tissue pocket and filled to a volume determined in the sizing step.

What is claimed is:  
     
         1 . A surgical method comprising the steps of: 
 providing an inflatable tissue expanding device, said device being reversibly expandable between a deflated condition and an expanded condition;    making an incision through skin;    inserting the device into the incision;    advancing the device into a fascial cleft between a chest wall and a pectoralis major muscle in a human breast to a location where it is desired to create a tissue pocket;    inflating the device with a fluid to dissect the tissue layers defining the fascial cleft between the chest wall and the pectoralis major muscle to the anatomical boundaries of the fascial cleft to create the tissue pocket to the anatomic boundaries of the tissue layer;    deflating the device;    removing the device through the incision; and    inserting a prosthesis into the tissue pocket.