New Device Let Jessica Control Her Breast Tissue Expansion at Home

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

Jessica holds AirXpander remote to her chest

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, a 41-year old Fenton resident who ate healthy foods and did daily fitness workouts.

It could have been a very dark winter — with trips to the doctor, medical tests, and surgery. But Jessica found a purpose. The disease could help her become a better person, find her inner strengths, face her fears, and accept her limitations.

With an open mind and a positive attitude, Jessica evaluated her choices about breast reconstruction. Her surgeon, Dunya Atisha, M.D., director of Breast Reconstruction and Microsurgery at Henry Ford Health System, explained that during the double mastectomy, temporary 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, says Dr. Atisha. Jessica and her husband, an engineer, were very interested in the new technology. Also, she had the desire to follow directions and the willpower to do the expansion process at home.

As Dr. Atisha explained how to use the remote-controlled device, a video was created for Jessica to review at home, if necessary.

“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.

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

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

But before Jessica could complete her reconstructive process, she had to cope with upcoming surgeries, 16 rounds of chemotherapy, and 28 days of 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.

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The road to reconstruction

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 and the patient would record the amount they put in with each expansion.

“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.

However, 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.”

“I’ve been 98 percent satisfied,” she says. The only downside was that a small amount of air was released each day, but it wasn’t a significant reduction.

“The released carbon dioxide is not harmful. It goes into the blood stream, and we already have air in our blood,” says Dr. Atisha. Carbon dioxide is a byproduct of what we breathe every day.

After the expansion process is complete, the average patient will continue to have the expander implants in place for five months. However, patients who need chemotherapy and radiation will retain the implants for 9-12 months, says Dr. Atisha.

There are more surgeries upcoming for Jessica. Soon she will have her tissue expanders removed and replaced with permanent implants. In four to six months, she’ll be in the operating room again to have her skin grafted to create a nipple and areola and to have fat taken from other parts of her body and injected into her breasts.

Focused on the positive

Jessica and her dogAs a transition specialist, Jessica helps special-education students become more independent after high school. As a double-mastectomy patient, Jessica calls herself blessed as she helps other people overcome challenges.

She looked for the positive aspects of breast cancer, not the negative ones. Her optimism was fostered by reading helpful books, posting inspirational quotes and messages on social media, and surrounding herself with an army of encouraging supporters.

“My goal was to help other people get through any struggle they were facing. I could implement my hard time so I could help others,” says Jessica. To manage stress, Jessica practiced meditation. “It was important to turn off my mind and get some good rest.”

As Jessica reflects on the past 12 months, she’s realized that she has an army of support — friends, family, community, and a surgeon whom she trusts.

She’s learned that she can continue exercising, no matter how little she can do.

She’s learned to encourage people in spite of her pain.

And she’s learned that she can say, “If God keeps blessing me throughout this journey, I’ll be OK!”

Jessica’s advice to other breast cancer patients

We’re all going to have bad days — whether or not you get diagnosed with cancer. She says: I’d encourage people to have a positive mindset and support system. Even though you may want to be private, find others who have been through a similar journey. Don’t try to do this on your own. I would definitely read encouraging books, surround yourself with good people, trust in God, and believe he will see you through.

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