The Keller funnel is the latest innovation for breast augmentation with silicone gel implants. It allows me to place an implant through an incision that is hardly bigger than the one used for saline implants. It keeps the implant from touching the skin, a benefit because the cause of capsular contracture is thought to be related to skin and breast tissue bacteria getting on the implant. These bacteria set up housekeeping and protect themselves with a biofilm and secrete substances that irritate the pocket lining cells and make them contract.
This device will help us maintain our already low contracture rate of 1-1.5% and possibly improve on it. Nationally, contracture rates run 7-10%.
One of the real benefits of the Keller Funnel is to allow placement of gel implants through small incisions and to get the smallest possible incision. For example, implants up to about 450 cc can be placed through an incision of 3.75 cm or less, and larger implants in the 475-600 range can be placed through an incision that is 4-4.75 cm. This is much better than the 5.5 to 6.5 cm incision that used to be needed.
Since the implant goes through the funnel without contact with the skin or surgeon’s hands, there is theoretically a lower risk of capsular contracture and the procedure is faster and smoother and definitely less traumatic to the implant.
For patients who want incisions through the periareolar (nipple) approach, the size used to be limited by the size of the areola. While this is still true, there is a much larger range of sizes that can be introduced through the periareolar incision. Now, for areolas with a diameter of 4 cm, I can expect to place implants of up to 550. Since the majority of women desire implants smaller than that, the areola is now a very viable choice for women who want silicone gel implants. The same goes for the underarm incision that used to be limited to about 300-350 gel implants or smaller.
For more information on the Keller Funnel™, see the follwing link: Keller Funnel™
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