I perform a lot of breast augmentations, especially as we approach the warm summer months. While my results have been excellent, there are a few things that we as plastic surgeons have little control over: the development of capsular contracture, implant rupture, and poor scarring. Of course, we use a variety of techniques to reduce the incidence of these things, but there still remains a large unknown component.
Recently, I came across a new device to be used in breast augmentation. It is called the Keller Funnel, developed by a Texas Plastic Surgeon. The device resembles a pastry bag. A silicone breast implant is placed inside this bag and essentially squeezed into the surgical opening in the breast.
While very simplistic in its actual design, the concept is exceptional. It allows for a truly “no touch” implant technique. This device allows the surgeon to place the implant, without having it come in contact with his hands or the patient’s skin. This reduces potential bacterial contamination, reduces infection risk, and more importantly, may reduce capsular contracture. Capsular contracture is the development of abnormal scar tissue around the implant, resulting in an implant that looks distorted and feels hard. No one knows why capsular contracture develops in some people, but a leading theory is that a small amount of bacteria on the implant may lead to the development of this abnormal internal scar tissue. It may also be the result of the talc commonly found on a surgeon’s glove. The “no touch” technique is an important concept and until this funnel, was only possible through very large incisions.
In addition, a large amount of pressure is needed to force a large silicone implant through a small incision. This immense force may contribute to a weakened shell and a delayed rupture of the implant years later. The rupture rate has been estimated to be as high as 7% over the first 10 years. The breast funnel allows insertion of the implant with much less force, thereby potentially reducing the incidence of implant rupture.
Lastly, using the breast funnel, I am able to place the implants through a significantly smaller incision. This shorter incision means a shorter scar, and a happier patient. I have reduced the length of my incisions 1 cm.
I am still among a small group of plastic surgeons who have incorporated the breast funnel into their practice. Since I began using it, my incisions are smaller, my operating time has decreased, and my patients have been extremely pleased. In terms of the potentially reduced rate of implant rupture and capsular contracture, only time will tell. The funnel is now a routine part of my breast augmentation procedure and the reason why patients choose me as the surgeon when there are hundreds of other surgeons nearby to chose from.
Dr. Schulman discusses the many benefits of the Keller funnel:
To learn more about breast augmenation, contact my New York City office to schedule a consultation.