New Device Let Jessica Control Her Breast Tissue Expansion at Home

Implants expand with air. No needles. No weekly visits to the doctor.

Jessica Linders received a life-changing diagnosis in December 2017 — she had invasive and fast-growing, lobular breast cancer and a genetic mutation, called BRCA 2. Her treatment would include a double (bilateral) mastectomy and surgery to remove her ovaries and fallopian tubes.

“The first thing I asked myself was ‘why me?’” says Jessica, who ate healthy foods and did daily fitness workouts.

With an open mind and a positive attitude, Jessica, 41, evaluated her choices about breast reconstruction. Her surgeon, Dunya Atisha, M.D., director of Breast Reconstruction and Microsurgery at Henry Ford Health, explained that during the double mastectomy, temporary tissue expanding implants would be inserted into her chest cavity.

Option one: Use implants that would expand when weekly injections of saline were given while in the doctor’s office.

Option two: Use implants that would expand with air. No needles. No weekly visits to the doctor. In the convenience of her home, Jessica could use a remote-controlled device to gradually fill the implants with 10 cc’s or more of carbon dioxide a few times a day. Designed to provide women with more independence, the implants — AeroForm AirXpanders — also reduce the risk of infection from needle-sticks.

“It was a done deal,” Jessica says. “Just knowing I didn’t have to have another needle stuck in my chest helped me make the decision.”

Jessica was a good candidate to use the air expanders because she had the desire to follow directions and the willpower to do the expansion process at home, says Dr. Atisha.

“The air-expansion process eliminates fear and anxiety for many patients,” says Dr. Atisha. “A lot of women hear or read horror stories about tissue expansion. For some women, the process of weekly saline injections can feel tight and painful for 24-72 hours.

“But if the patient controls the process, it is less painful. The woman regulates how much air is used and on what days it is used. Patients can pump themselves up a little each day, or they can take a break for a day or two.

“This technology revolutionizes the expansion process,” says Dr. Atisha.

“Dr. Atisha had built a great rapport and got to know me as a person,” says Jessica. “I would trust her with any decision about my breast reconstruction process.”

Currently, the plastic surgeons at Henry Ford are the only physicians in Michigan that offer air expanders to their patients.

Air expanders are one of the many breast cancer care innovations now available at the Henry Ford Cancer Institute, including:

• A new 3D breast screening option called ABUS, or Automated Breast Ultrasound System, which is improving breast cancer diagnosis for women with dense breast.
• And, another needle-free advancement, called Magseed marker, which is helping to guide our breast cancer surgeons during lumpectomies for nonpalpable breast cancer. Placed prior to surgery, the radiation-free marker is smaller than a grain of rice, replacing the need for several long needles to be inserted in the breast prior to surgery.

The road to reconstruction

Before Jessica could complete her reconstructive process, however, she underwent chemotherapy and radiation therapy. Tissue expansion is typically done before radiation therapy. That’s because radiation can act like a sunburn and may cause skin to tighten.

The process of gradually expanding the skin was a simple one:

• Near her chest, Jessica held up a wireless device that looked like a small remote control, and she pressed a button to activate the electronics in her temporary implant.
• Inside the implant, a reservoir contained compressed carbon dioxide. The air was gradually released in small amounts into her expander.
• The process could be repeated three times a day.

“It was cool that I could wave a medical wand over my breast and control the air flow as I expanded myself,” says Jessica. “It’s a little like blowing up a balloon. You can see the expansion and feel a little of the air pressure.”

She says that she was expanded in four weeks — faster than the average saline breast implant patient. One research study showed that saline expansions can take a median of 46 days.

Expansion varies depending on the size of the woman, the amount of air used each week, and the patient’s comfort level. “Everybody’s experience is different,” says Dr. Atisha.

Did the expansion process hurt?

Jessica laughed, “The only time it was painful was when the doctor expanded me the first time with 30 cc’s of air after surgery. I went from being big busted, to flat, and then to being expanded.” After the expansion process is complete, the average patient will continue to have the expander implants in place for five months. Patients who need chemotherapy and radiation will retain the implants for 9-12 months.