This paper presents a critical review of the results of tissue expansion in our clinical experience. Seventy-six expansions performed in 66 patients between 1981 and August 1986 are included in the study. Complications necessitating some revision in the original treatment plan were documented in 39% of cases. However, sufficient tissue was usually generated to complete the proposed reconstruction without compromising the final results. The complications of tissue expansion are further analysed in relation to their anatomical distribution, time of onset and ultimate consequences. Causative factors are identified and preventative measures are introduced.