What is the need for breast reconstruction?
Dr. Desai: Women that are diagnosed with breast cancer have a multitude of options, but one of the options is that they get a mastectomy. Some undergo prophylactic mastectomy and some do it because of the size of the cancer. We strive to provide women with reconstructed breasts than are better than they once had before. I think that reconstruction has evolved over time. Twenty to thirty years ago it was about finding something that looked good to fill a bra and looked good in clothes. Now the demands and the techniques have improved in that It’s not just about filling a shirt or a bra but it’s actually looking esthetically pleasing to the naked eyes.
What is the chief complaint that comes along with the traditional way of doing things with saline injection?
Dr. Desai: Before we would do an implant base reconstruction, that’s one of the most common ways to do breast reconstruction. We put in a tissue expander and they have a port that we can inject saline into. Patients come to the office, usually about once a week, and we inject a needle through the skin into the port of the saline tissue expander and then inject a bolus of saline. That’s how we stretch that skin envelope to recreate that pocket for what eventually will be the permanent implant.
The saline expander limitations are the frequent doctor visits. The patients have to come once a week to the office for these injections. They have to have a needle that’s stick through the skin which sometimes can cause some discomfort for the patients.They get a bolus injection, meaning they get at least about sixty cc’s at a given point in time. The reason for that is, you can’t have them come to the office every day for expansion. If you look at anything the most natural way of expansion is little by little, multiple times a day, every day. You see women over nine months undergo gently gradual tissue expansion and that’s nature’s most natural tissue expansion. As plastic surgeons we’re always trying to recreate tissue. When we recreate tissue or expand tissue for bones and jaws for younger kids, they actually undergo daily expansion of the bone. They get a little half turn of a screw twice a day. We haven’t been able to simulate something like that with saline breast reconstruction. That’s what’s wonderful about the Aeroform technology. It will allow us to more gradually expand the patient and I think that the satisfaction and comfort for patients are going to be higher.
You are gradually expanding but in essence, you’re able to get the reconstruction going much faster, correct?
Dr. Desai: The advantages of the aeroform expander are less pain because you’re gradually expanding multiple times every day. In addition, the overall expansion takes less time. If you look at our growing data and research that’s out there traditionally, saline tissue expansion is on the average of about three to four months and Aeroform expansion is really within weeks to a month. The patients are completed with their expansion in a month and that’s primarily because they can do it every day, it’s more comfortable and they’re getting a more gradual expansion. Gradual expansion also means a better aesthetic result in my opinion because we’re not putting a lot of pressure on the skin so the skin and the muscle thins out less and you get a better coverage of your permanent implant.
How does this compare to something like Bravo?
Dr. Desai: Bravo is external tissue expansion and it uses suction to actually expand the skin and the soft tissue envelope from the outside. It is temporary, it doesn’t create an internal pocket for a permanent implant. If you use the Bravo for external tissue expansion and then stopped using the Bravo then your breast, if you had a mastectomy, go completely flat again. If you did it and you went to go put an implant in there’s really not a space to put an implant like there is with a traditional saline tissue expander or the air expander. Typically the Bravo technology is used for external tissue expansion and then to inject fat in to that area.
What’s been the response so far in the trial?
Dr. Desai: I think patients are really excited about it. They don’t have to have a needle stick; they don’t have to come in to the doctor’s office as frequently. When I tell them about it they immediately jump on board. Patients not only are excited about it but they find that it’s more convenient. They can do it at home.
END OF INTERVIEW
This information is intended for additional research purposes only. It is not to be used as a prescription or advice from Ivanhoe Broadcast News, Inc. or any medical professional interviewed. Ivanhoe Broadcast News, Inc. assumes no responsibility for the depth or accuracy of physician statements. Procedures or medicines apply to different people and medical factors; always consult your physician on medical matters.
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