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Remote-control device could make breast reconstruction more bearable for Anne Arundel cancer survivors

04 / 05 / 2018

Capital Gazette - Selene San Felice - Contact Reporter

When Melanie Hambleton learned she'd need a mastectomy to complete her breast cancer treatment, she was devastated.
"I thought I was going to be physically ruined," says the 40-year-old Royal Oak resident.
Instead, Hambleton was one of 40 women in the area to use a new breast reconstruction technology that felt almost like a video game.

Getting breast implants after a mastectomy typically involves weekly doctor's visits, a needle, saline and an uncomfortable, sometimes painful process. But Drs. Devinder Singh and Tripp Holton of the Anne Arundel Medical Group have begun offering an alternative that allows patients to expand their breast tissue at home with a remote-control device.
Three times a day, Hambleton followed this routine:
She would click a button on her remote. "Bee-oop." A green light flashed to signal the remote is on.
"Beeeeeeeep - da-da-da-dada!" three green lights blink in victory.
The victory tune signaled that a tiny puff of air (10 milliliters) was released from a quarter-sized cartridge into her tissue expanders, inserts where her breast implants would go.

The remote control, part of the AeroForm tissue expander system, connects to the expanders in a patient's body through a sort of Bluetooth technology, allowing the patient to dose herself anywhere and any time with three puffs a day, at least three hours apart. If she tries to dose too soon or go over three doses, the remote emits a harsher tone with flashing red lights, locking up until it's time for the next dose. Game over.

The system is an alternative to the traditional method of tissue expansion still used at most hospitals, during which patients visit their doctor once a week to have 50 milliliters of saline injected into each expander between the skin and pectoral muscle. This is a slower process, filling waiting rooms with patients who have to make the trip to get their weekly injections. There are also small risks of infection or popping the saline-filled expander with the needle. One 50 milliliter fill-up a week can result in more pain and stretching than 30 milliliters gradually every day.

When given the two options, Hambleton says it was a no-brainer. If she felt any discomfort or stretching, she could always choose not to give herself the second or third dose of the day.
"It felt like I was playing more of an active roll in my healing," she says.

For patient Frances McFarland, 46, of Annapolis, the beeps and flashes of the AeroForm remote were a perk of getting perky.
"The first time I heard that victory chime, I started giggling," she says. "It never got old, inflating my own breasts. And I'd cackle like a madwoman while doing it. ... I felt free."

While AeroForm was the preferred method for Hambleton and McFarland, it's not for everyone. Once the air puffs out of the cartridge, it's out for good. No do-overs.
"The genie doesn't go back in the bottle," Singh said. "With saline, you can make the expanders smaller by extracting some of the fluid."

Singh and Holton were among the first plastic surgeons to use AeroForm in in the Mid-Atlantic, according to the medical device company. Why? AeroForm is double the cost up front compared to the saline method. But Singh and Holton say that if hospitals can look past that initial cost, they'll save more in time and resources.
"It was a fight to get this," Singh says.

The doctors are looking to persuade other hospitals to switch to AeroForm as well.
"The future is here," Holton says. "The question is, who gets to have it?"