Jeffrey Ascherman, MD
Jeffrey Ascherman, MD, is a professor of clinical surgery at NewYork-Presbyterian Hospital/Columbia University Medical Center in New York City and principal investigator for this study on the CO2 tissue expander.
After the wrenching experience of mastectomy, breast reconstruction can help restore a woman’s sense of wholeness. Yet fewer than half of US breast cancer patients opt for reconstruction—perhaps in part because they are discouraged by the lengthy and sometimes painful process of expanding the chest tissue in preparation for a breast implant. Fortunately, a new do-it-at-home expansion technique currently being tested may soon make that prep much easier and quicker. Here’s the scoop…
Typically, when a woman plans to have reconstructive surgery after mastectomy, the first step is to have a balloonlike tissue expander implanted beneath the chest skin and muscle. Then, during weekly doctor visits over four to six months, saline is injected into the expander to stretch the chest tissue and create a “pocket” to hold the permanent breast implant. The process is inconvenient…and both the injections and the sudden stretching can be uncomfortable.
Innovation: The new technique uses carbon dioxide (CO2) gas rather than saline. First, a small expandable device is implanted in the patient’s chest. Then, up to three times a day, the patient activates the expander using a remote control. This releases a premeasured amount of compressed CO2 from an internal reservoir, inflating the expander a bit and gradually stretching the tissue day by day. A built-in control prevents accidental “overdoses,” and the expander is removed when the reconstruction surgery is performed. Early testing suggests several potential advantages…
Discomfort can be minimized because there are no needles and the patient controls how quickly the tissue expands.
It’s convenient. Since the patient activates the device herself at home, repeated doctor visits for injections are not needed.
In preliminary testing, the CO2 system has been much faster than saline, achieving the required degree of tissue expansion in several weeks rather than the months required for saline.
Interested patients: The CO2 tissue expander is not yet on the market, but a clinical trial is currently recruiting participants at several major medical centers across the country. Eligible participants include mastectomy patients planning reconstruction who are between ages 18 and 70…are nonsmokers…are not obese…do not need postoperative radiation and do not have radiation-induced skin damage…and do not have an implanted electronic device (such as a pacemaker). Patients interested in volunteering can visit www.ClinicalTrials.gov (type “NCT01425268” in the search box). To watch a manufacturer’s video on the new expansion device, go to http://bit.ly/JiH4qx.