DIY breast reconstruction: Device gives women control
This might be the ultimate do-it-yourself project: Doctors are testing a device that would let women do part of their own breast reconstruction at home.
It’s aimed at not only making treatment more comfortable and convenient, but also giving women a sense of control — something cancer often takes away.
More than 100,000 women each year in the United States have surgery to remove a cancerous breast, and many of them choose reconstruction with an implant.
To make room for a permanent one, many of them get a tissue expander, a temporary pouch that is gradually enlarged with saline to stretch the remaining skin and muscle.
This means trips to the doctor every week or two for several months for injections of saline into the pouch, which can be a painful ordeal.
“We would put as much saline as we could until basically the patient would say, ‘I can’t stand it anymore,’ ” said Dr. Daniel Jacobs, a Kaiser Permanente plastic surgeon in San Jose, Calif.
While biking home one day, Jacobs had an idea: Why couldn’t a tiny can of compressed gas, like the one he carries to fix a flat tire, be used to let women inflate their own tissue expanders, a little each day so there is less stretching at a time and less pain?
He helped found a company — AirXpanders Inc. of Palo Alto, Calif. — to develop the device, called AeroForm.
It’s sold in Australia, approved in Europe and under review by the U.S. Food and Drug Administration.
Its use requires no special training, wires or tubes — just a palm-sized remote control that activates a tiny cartridge inside the pouch to pump gas, up to three times a day according to how the woman feels.
In a company-sponsored study of 150 women, AeroForm patients finished tis- sue expansion in half the time and were able to get implants a month sooner than others who had the usual saline treatments, said the study leader, Dr. Jeffrey Ascherman, a plastic surgeon at New YorkPresbyterian/ Columbia Medical Center in New York.
“My patients love it,” he said.
There was no difference in rates of side-effects such as infections, but seven of the air expanders malfunctioned versus only one saline one, Ascherman said.
The device was tweaked to fix the problem, he said.
“It’s a really interesting concept,” said one outside expert, Dr. Deanna Attai, a University of California at Los Angeles surgeon who is a past president of the American Society of Breast Surgeons.
“Giving the patient a sense of control is very psychologically important,” because many women feel robbed of that, Attai said.
“To a patient that’s going through cancer treatment that could be a big deal.”
Luincys Fernandez demonstrates how she used the AeroForm hand-held dosage controller to stretch skin and muscle to make room for an implant after breast cancer.