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

Woo, Joo Hyun; Seung, Ik Hyun; Hong, Seung Eun

doi:10.1016/j.bjps.2020.08.078

Cited by 5 publications

(5 citation statements)

References 27 publications

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“…Montemurro et al 23 used single antibiotics (clindamycin), anatomical implants, and inframammary fold (IMF) incision. Woo et al 24 used double antibiotics (gentamicin and cetrazole), anatomic implant (silicone gel), and peri areolar incision. Jang and Kim 25 used different implants, such as anatomic implants, smooth, cohesive gel, and round microtexture, and used IMF incision.…”

Section: Resultsmentioning

confidence: 99%

“…Two studies were identified discussing the role of Keller funnels in breast reconstruction. Woo et al 24 assessed nipple-sparing mastectomies with periareolar incisions and immediate alloplastic breast reconstruction utilizing a funnel and ADMs, and one patient had radiotherapy. There were 21 participating patients (mean age, 45 years), with two of them receiving bilateral breast reconstruction.…”

Section: Resultsmentioning

confidence: 99%

“…Although traditionally used in aesthetic procedures, barrier funnels also have utility in breast reconstruction. Woo et al 24 performed prepectoral implant placement via a periareolar incision. To mitigate the size of periareolar incisions in nipple-sparing mastectomies, the authors used a funnel (ART funnel) for insertion of an implant completely covered with ADM. Due to the higher rate of complications with single-state alloplastic reconstruction, including flap necrosis and implant extrusion, many surgeons prefer to delay implant-based reconstruction.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Keller Funnel Efficacy in “No Touch” Breast Augmentation and Reconstruction: A Systematic Review

Morkuzu

Özdemir

Leach

et al. 2022

Plastic and Reconstructive Surgery - Global Open

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Background: Breast augmentation is one of the most common aesthetic surgical procedures. Tissue expansion followed by permanent implants is the most frequent postmastectomy breast reconstruction method. Implant contamination remains a critical problem with these procedures‚ resulting in acute infection as well as capsular contracture. To reduce the risk of implant contamination, the “no-touch technique” utilizing the Keller funnel has been adopted by many surgeons. This systematic review aims to investigate the advantages of the Keller funnel method for breast augmentation–reconstruction. Methods: A systematic review of PubMed, Embase, the Cochrane database, and Google Scholar was performed between 2005 and 2021. All clinical-based, retrospective and prospective studies utilizing the Keller funnel method for breast implant insertion were selected. Results: Six studies were identified for evaluation: five were retrospective cohorts and one was a prospective trial. No randomized controlled trials were found. Outcomes reported included lower rates of capsular contracture (RR, 0.42; P = 0.0006; 95% CI, 0.25–0.69), shorter incision lengths (35.5 ± 2.1 mm), less insertion time (mean = 6 seconds), and decreased complications, and one paper reported ultimately greater patient satisfaction with outcomes (BREAST-Q Score: 92%). Conclusions: This review suggests that the Keller funnel is a useful method for no-touch breast augmentation and reconstruction surgery. The Keller funnel reduces subsequent capsular contracture rate, surgical time, and incision length and allows for easier insertion. However, our findings support recommendation of a prospective randomized controlled clinical trial with larger population size and follow-up intervals.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Keller Funnel Efficacy in “No Touch” Breast Augmentation and Reconstruction: A Systematic Review

Morkuzu

Özdemir

Leach

et al. 2022

Plastic and Reconstructive Surgery - Global Open

View full text Add to dashboard Cite

show abstract

“…Using the funnel also reduces capsular contracture, results in only a small postoperative scar, and is associated with relatively mild postoperative pain. Due to these advantages, funnels are now used considerably more frequently during breast augmentation and reconstruction using implants [12][13][14][15].…”

Section: Discussionmentioning

confidence: 99%

Delivery technique for the pedicled transverse rectus abdominis myocutaneous flap

Lee

Kwon

Lee

et al. 2022

Arch Aesthetic Plast Surg

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The pedicled transverse rectus abdominis myocutaneous (TRAM) flap is often used during breast reconstruction. After completely elevating the flap, a medial tunnel is created to connect the dissection area to the mastectomy defect. This tunnel should typically accommodate four of the surgeon’s fingers, although this may vary depending on flap volume. Wider tunneling facilitates flap delivery, but can damage the breast and inframammary fold. Therefore, we introduce a technique to move the flap easily and safely through a small tunnel. During breast reconstruction using a pedicled TRAM flap, a tunnel was made in the mastectomy defect along the meridian of the breast. This tunnel accommodated a width of three of the surgeon’s fingers (6 cm). After completely elevating the flap, it was inserted into a funnel with an inner surface made of polymeric vinyl and a hydrophilic coating. The flap was propelled into the mastectomy defect via the funnel. Our novel technique for pedicled TRAM flap delivery using a funnel was easy and safe, and it is deemed to be suitable for delivering a pedicled TRAM flap.

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“…Acellular matrix derived from bovine pericardium was used for coverage of the subcutaneous PI in those with NSM and both had NAC ischemia and infection, resulting in implant failure in 1. Subcutaneous PI is usually covered with acellular dermal matrix (ADM) which relieves the pressure on the skin flaps and provides more natural pseudo-ptosis and inferior pole projection compared to submuscular pocket (18). It decreases the rate of capsular contracture but causes increased seroma formation, implant failure, partial NAC necrosis and rippling (19).…”

Section: U N C O R R E C T E D P R O O Fmentioning

confidence: 99%

Can Skin Sparing Mastectomy and Immediate Submuscular Implant-Based Reconstruction Be a Better Choice in Treatment of Early-Stage Breast Cancer?

Kayahan¹

2022

EJBH

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

Cited by 5 publications

References 27 publications

Keller Funnel Efficacy in “No Touch” Breast Augmentation and Reconstruction: A Systematic Review

Keller Funnel Efficacy in “No Touch” Breast Augmentation and Reconstruction: A Systematic Review

Delivery technique for the pedicled transverse rectus abdominis myocutaneous flap

Can Skin Sparing Mastectomy and Immediate Submuscular Implant-Based Reconstruction Be a Better Choice in Treatment of Early-Stage Breast Cancer?

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