Face and neck is one of the most important parts of human functional structure and morphological appearance. The malignant lesion area of facial and neck nevus is large, which leads to the skin defect can not be directly sutured after resection. The color and texture of skin graft after traditional skin grafting are obviously different from the surrounding skin, which affects the cosmetic effect. Skin expansion has the advantages of providing extra skin that matches the texture, color, thickness and feeling of the recipient and reducing the damage of the donor site. Then experts from Shijiazhuang Xingyuan Plastic Surgery Hospital tell you. The method of dilator resection: draw the outline of dilator and the position of embedding injection pot with methylene blue on the skin surface of the area where dilator is to be buried. Under local infiltration anesthesia or general anesthesia, the skin is cut along the edge of the nevus or other quasi-incision lines, and the face is as deep as the superficial fascia layer and the neck is as deep as the superficial platysma muscle. This layer uses a combination of blunt and sharp tissue cutting to peel off the implant cavity, which is larger than the contour of the dilator. Stripping should be carried out under direct vision as far as possible to facilitate full hemostasis. Rinse the hematocele and free fat particles in the cavity with normal saline, and after confirming that there is no active bleeding, bury the dilator flat, and place a water injection kettle on the other side of the incision to avoid the connecting catheter between the water injection kettle and the expansion sac from folding and blocking. After the wound is sutured, the dilator should be filled with a small amount of water and properly pressurized, and each dilator should be placed with negative pressure drainage (the indication of pulling out the drainage tube is that the drainage volume is less than 24 hours or the extracted liquid is light yellow to prevent hematoma from forming. The stitches were removed 7~ days after operation. Then inject normal saline twice a week to dilate. After the water injection is sufficient, the second operation is performed: the skin is cut through the original incision, the dilator is taken out, and the black spot nevus tissue is taken out, so that the expanded skin forms a local push or rotation flap to cover the defect area. If the tension is too high when transferring the flap, the fibrocyst formed after expansion can be partially cut or peeled off, and layered suture can be placed for negative pressure drainage. Apply appropriate pressure to wrap all peeling areas. Surgical skills of dilator: 1 2