By Jeffrey Ascherman, MD
According to a recent assessment from the Agency for Healthcare Research and Quality, the rate of women undergoing mastectomies increased 36% between 2005 and 2013, and bilateral mastectomies more than tripled. As more women than ever before are choosing mastectomy as a breast cancer treatment or preventative measure, it’s important that plastic surgeons are informed about the latest breast reconstruction technology.
Although two-stage reconstruction has been practiced successfully for decades, existing saline expanders have limitations. The saline injections required to inflate the expanders can be uncomfortable, inconvenient, and time-consuming. Furthermore, the associated expansion visits can require significant time and resources from the plastic surgeon’s practice.
New technology, however, may soon offer women and surgeons another option. Columbia participated in a clinical trial for a novel expander that gives patients the ability to control the expansion process using a small, wireless controller. Using the controller, the patient delivers a small dose of compressed gas to gradually fill the expander. For the plastic surgeon, this eliminates the time and equipment needed for sterile saline injections, and for women, this new technology offers more autonomy and the ability to return to their daily activities faster.
In a randomized clinical trial, median days to complete expansion for the investigational device was significantly faster at 21 days, compared to 46 days for the saline group. Following expansion, both groups went on to the final stage of reconstruction: exchange of the expander and placement of a long-term breast implant. Treatment success rates for both devices were similar.
At a time when new technology has the possibility of significantly changing how reconstruction looks and feels, it’s more important than ever that surgeons stay educated about the way the industry is evolving.
Jeffrey Ascherman, MD, is chief of the division of plastic surgery at Columbia University in New York.