Since its introduction 5 years ago, the Keller Funnel – a device used for insertion of silicone breast implants – has reduced capsular contracture rates, according to a multi-center study in which I participated. Though it looks more like something out of a pastry chef’s kitchen than a surgical instrument, the Keller Funnel makes insertion of the implant easier and gentler. It also facilitates a strategy known as the “no touch” technique, believed to be important in reducing the odds of capsular contracture (CC).
Despite improvements in techniques and technologies over the years, yielding better and more consistent results with breast augmentation, the problem of capsular contracture – a hardening of the natural scar envelope that forms around implants – hasn’t gone completely away. The most common cause of CC is believed to be microbacterial colonization known as biofilm, invisible and ordinarily harmless. When trapped on the surface of an implant however (any implant, not just breast implants) the scar capsule becomes more reactive, leading to thickening and hardening. The bacteria associated with biofilms live on the skin and in the ducts within the breast tissue, and even a vigorous surgical prep can’t eliminate them completely. Contact with bacteria can be minimized with antibiotic irrigation in the pocket before implant insertion, and a no-touch technique, meaning avoiding contact with the skin and breast tissue. The Keller Funnel enables the implant to be inserted with minimal manipulation directly into the pocket.
So does this translate into measurably lower CC rates? The study mentioned above, which included my facility and 8 others around the country, compared our CC rates for the 3 years before using the Funnel to the first 3 years after adopting it. All were experienced board-certified plastic surgeons, with an average CC rate of 1.43% prior to Funnel use, with at least one year follow-up. This dropped to 0.66% with the Keller Funnel. With published data suggesting CC rates of 16% or more with silicone implants, these numbers are very reassuring. CC normally requires surgery including implant replacement, so the cost of using the Funnel seems well worth it, even though implant manufacturers now have a CC warranty to provide the implant at no cost.
More info about the Keller Funnel and video here: https://www.kellerfunnel.com/