While current implants offer excellent results in breast augmentation, they are not perfect. One of the concerns both before and after breast augmentation for many patients is…what if they are not big enough? And even if they appear of good size right after surgery, some women will eventually feel after time that they are not adequate anymore due to their familiarity with them. So it would useful if one could simply change the size of the implant a little bit without the need for further surgery.
The idea of an after surgery adjustment to the volume of a breast implant has been around for some time. It is not an obscure concept and is used regularly as a basic breast reconstruction technique. And it is used by a few plastic surgeons in cosmetic augmentations who employ these same tissue expanders that are regularly used in breast reconstruction to achieve that feature. Through indwelling or remote ports, extra saline can be added to increase the size of an indwelling saline breast implant. The ports are a nuisance, however, as they might felt on the side of one’s chest and as a result they are not a standard breast augmentation technique.
While the use of postoperative adjustable breast implants for cosmetic augmentation is not around the corner, a potential technologic advance is being developed in breast reconstruction. Usually what happens in breast reconstruction eventually finds its way to cosmetic breast applications as well. Tissue expanders following a mastectomy requires weekly office visits to add saline to the expander to gradually increase its size. Having a non-invasive or even a self-inflating method for breast tissue expanders would be a significant patient benefit, eliminating office visits
AirXpanders of Calidfornia has announced that they have enrolled their first patient in an FDA trial to study their Aeroform technology in breast reconstruction. This would allow women to control the expansion of their implant using a remote control. AeroForm implants have an indwelling CO2 cartridge which is connected to a wireless controller that regulates how much gas is released into the expander. The rate of the gas release can be regulated by the patient based on how tight or comfortable their breast feels. This offers the option of even small amounts of daily tissue expansion which is ideally tolerated by the breast tissues.
It is perhaps no surprise that remote and micro-controlled technologies, so widely available in many other industries, are being developed for active indwelling medical devices. The concept and the technology is fairly simple but adding them to a medical device and the regulatory and safety hurdles that must be overcome are not insignificant. It will be interesting to see not only how successful the AeroForm implant performs in patients but whether the costs involved merit commercial introduction of the device.
Dr. Barry Eppley
Indianapolis, Indiana