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Updated: Jan 1, 2026

Single-Port Robotic-assisted Transaxillary Breast-conserving Surgery: A Prospective, Single-arm, Non-randomized Phase IIa Clinical Trial
Published on: August 19, 2025
Results of XPAND II: A Multicenter, Prospective, Continued-Access Clinical Trial Using the AeroForm Tissue Expander
Jeffrey A Ascherman1, Kamakshi Zeidler1, Kerry A Morrison1
1From the Division of Plastic Surgery, Columbia University College of Physicians and Surgeons, Columbia University Medical Center-New York Presbyterian Hospital; Aesthetx: Aesthetic and Reconstructive Plastic Surgery; Mohebali Plastic Surgery; Novant Health Appel Plastic Surgery; the Division of Plastic Surgery, University of Massachusetts Memorial Medical Center; the Division of Plastic Surgery, Massachusetts General Hospital, Brigham and Women's Faulkner Hospital, Harvard Medical School; and eSSe Plastic Surgery.
Background:
XPAND II was a prospective, multicenter, single-arm, open-label, continued-access study designed to confirm the results from the XPAND study, a multicenter, prospective, randomized study for breast reconstruction. The AeroForm device received clearance from the U.S. Food and Drug Administration in December 2016 based on the results of the pivotal XPAND trial, which compared the AeroForm to saline expanders.
Methods:
Fifty women were treated in the XPAND II study and implanted with the AeroForm device (86 devices). The study endpoint was successful completion of the second-stage surgery, and secondary endpoints were days to complete expansion and reconstruction, and patient/physician satisfaction. Following implantation, women were administered 10-cc doses of carbon dioxide at home up to three times daily. When adequate expansion was achieved, the expanders were exchanged for standard breast implants.
Results:
The primary endpoint (successful exchange to standard breast implant, precluding non-device-related failures) is 100 percent. All-cause interim success is 95 percent, with three subjects (four breasts) failing primary exchange because of non-device-related reasons. Median time to complete expansion was 21 days (range, 5 to 117 days). Median time to complete the reconstruction was 112 days (range, 55 to 329 days). Ninety-six percent of the subjects were very or moderately satisfied with the AeroForm expansion process.
Conclusions:
Results of the XPAND II continued access study confirm and improve on previous results from the randomized trial (XPAND). These results validate that the AeroForm patient-controlled, needle-free carbon dioxide tissue expander is safe and effective for two-stage breast reconstruction.
Clinical Question/Level Of Evidence:
Therapeutic, IV.
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