Follow-up to "Building a Better Mousetrap" posted June 2013.
The potential for a much improved method of tissue expansion as a part of breast reconstruction after mastectomy is closer to becoming a reality: interim data from studies of women who used AirXpanders for patient-controlled expansion continue to show promising outcomes compared to traditional saline expanders.
Most implant reconstruction involves the use of temporary expanders that gradually stretch the pectoralis muscle and breast skin to make enough room for an implant. The process typically takes several weeks (2 - 3 months), although some plastic surgeons proceed more conservatively (administering smaller and/or less frequent fills) or more aggressively (administering larger and/or more frequent fills).
AirXpanders introduce a kind of do-it-yourself expansion. They appear to produce similar results in a shorter timeframe, with less discomfort, and offer one big difference: the patient controls when, where and how much she is expanded, without needles or office visits. When the anatomically-shaped expander is in place under the muscle, patients use a wireless remote control to activate release of carbon dioxide from a small reservoir within the expander: up to three doses per day—each dose is 10cc—in their own home and at their own pace.
Study data presented at the annual meeting of the American Society of Plastic Surgeons (ASPS) in October reflect much shorter start-to-finish expansion intervals with AirXpanders. Jeffrey A. Ascherman, MD, FACS of New York-Presbyterian Hospital/Columbia University Medical Center, presented interim results from the XPAND study in the U.S., which included 138 women with AirXpanders who completed their expansion process in an average of 18.2 days. Women who were randomized to receive traditional saline expanders required 57.4 days on average to complete the process. (Previously published results of a similar trial in Australia found an average completion time of 17 days.)
Enrollment in the EXPAND study has currently reached the target of 138, but AirXpanders is extending the enrollment period.