Effect of Keller Funnel on the Rate of Capsular Contracture in Periareolar Breast Augmentation

Abstract

Background:Capsular contracture is 1 of the most common complications after breast implant surgery and is a major indication for reoperation. Capsular contracture is believed to be a multifactorial process that is affected by implant texture, incision type, and ultimately pocket contamination. This contamination causes a biofilm that leads to capsular contracture. The intraoperative use of a Keller funnel is a mechanical way to decrease the implant’s contact with the skin and ducts, reducing bacterial contamination that can cause these biofilms. For this reason, periareolar breast augmentation has been less popular among surgeons. The purpose of this study was to examine if there was a significant difference between the rates of capsular contracture in patients having periareolar breast augmentations with the use of a Keller funnel for insertion and those having periareolar breast augmentations without Funnel use.Methods:This level 3 retrospective study followed 2 groups of patients, the first having periareolar breast augmentations without the use of a funnel for insertion (group A; patients n = 15; implants n = 30) and the second having periareolar breast augmentations with the use of a funnel for insertion (group B; patients n = 151; implants n = 300).Results:The rate of capsular contracture in group A was found to be 10% compared with a rate of capsular contracture of 1.3% for patients in group B, an 87% reduction (P = 0.0019).Conclusions:According to the results found in this study, the rate of capsular contracture in patients having periareolar breast augmentations after insertion with a Keller funnel was statistically significantly lower than the rate in patients having implants inserted without the assistance of a funnel, making the device useful in reducing the occurrence of postoperative capsular contracture.

Funnel usefulness in direct-to-implant breast reconstruction using periareolar incision with prepectoral implant placement and complete coverage with acellular dermal matrix

“…12 Funnel use has also been shown to reduce capsular contracture. 24 With these advantages, funnels have been used considerably in cosmetic breast surgery. Funnels can also be effectively used in implant breast reconstruction, as confirmed in this study.…”

Precaution Costs: The Presumption of Breast Cancer Seeding and Its Impact on Surgical Expenditure

“…We have already extensively studied and published on infection control in breast tissue. 32 , 33 Of course, the breast case becomes inherently colonized over the course of the surgical procedure; however, the sources of the infectious agents are the nipple ducts and axilla, not the instruments. We have found no evidence in the literature to suggest that changing instruments leads to a decrease in surgical site infection rates.…”

Short-term Safety of a Silicone Gel–filled Breast Implant: A Manufacturer-sponsored, Retrospective Study

“…It has been reported that an implant-based augmentation mammaplasty via a periareolar incision produces a higher rate of CC. 20 , 21 Moreover, some “Core” studies have shown that the rate of CC was significantly higher in secondary cases than in primary ones. 6 , 12 , 22 , 23 Furthermore, the use of anatomical implants was closely associated with a decreased rate of CC.…”