Evaluation of AirXpanders for breast reconstruction: early experience from Sydney

Aim: Two-staged prosthetic breast reconstruction has become a popular option involving a series of saline injections to expanders to create a pocket large enough for a permanent implant. This, however, requires frequent visits to the surgeon and numerous needle pricks with potential infection risk. A new form of tissue expander, the AirXpanders, has recently been trialed in Perth and the United States. It uses a remote-controlled release of compressed CO₂ where needle punctures are avoided.

Methodology: Prospective data were collected on the first 10 patients to have the AirXpanders implant inserted for breast reconstruction at Western Sydney. The implants were inserted subpectorally as the saline expanders, and patients were instructed how to use the remote 4 weeks postoperation. 
Results: Ten patients (4 immediate and 6 delayed) aged between 30 and 65 (mean, 48.3 years) underwent 14 AirXpanders insertions. One patient passed away due to metastatic malignancy. With the remaining patients, the average period of active expansion was 15.8 days (r, 6-21). The average size of final implant used was 451 g (r, 195-685). The only complications were 2 seromas. 
Conclusion: Our early results are consistent with the Perth trial. The new AirXpanders is safe to use and able to achieve satisfactory tissue expansion faster than saline expander. It also has the advantage of patient self-controlled without the need for multiple medical reviews and needle punctures.