March 30th, 2013 Miguel A. Delgado Jr, MD
Dr. Delgado has been using the Keller Funnel for his San Francisco Bay Area patients for quite some time now. Always wanting the best possible results for all of his cosmetic surgery patients, he is on top of all new procedures and devices.
The Keller Funnel was brought to market in August 2009. It is a device designed for easier insertion of silicone breast implants for cosmetic plastic surgeons performing breast augmentation surgery. Patients seem to heal faster and adjust to their implants easier.
The funnel is a nylon pouch shaped like an icing bag with an interior coating of a special lubricant, allowing any style or size implant up to 800cc’s to be inserted. The narrow end is placed into the incision, and the surgeon squeezes the implant into the breast. The traditional delivery system for augmentation mammoplasty, the surgeon uses his finger tip to guide the implant through the incision into the pocket.
The Keller funnel is a one use “no touch” disposable device. It allows the surgeon to make a smaller incision with less stress on the implant; in fact an independent study claims the method reduces force applied on an implant by 95%.
Another advantage of a “no touch” technique is that it greatly reduces possible contamination. The breast is not a sterile organ; there is colonized bacteria living in the nipple ducts. Even with proper surgical preparation there is no guarantee of a completely sterile surgical field. Bacterial contamination is believed to be one of the leading causes of capsular contracture.
September 29th, 2012 Miguel A. Delgado Jr, MD
After breast augmentation surgery, Dr. Delgado has his patient begin breast massage exercises. This may be uncomfortable for a few days but is a very important step to soften and relax the breast implant pocket. Being vigilant with the massaging will greatly help in the prevention of a possible capsular contracture from forming around the implant which would prevent it from moving freely.
The body’s natural response to a foreign body (in this case the breast implant) is to form a lining around it by your own living tissue. This is referred to as the “capsule”. For some Marin County women, the capsule may tighten and squeeze the breast implant making it feel hard. Capsular contracture can happen at any time for anyone but seems more common after the first few months of surgery.
The degree of contracture is graded on what is called the Baker Grading system. Baker Grade 1 is where the breast is normally soft and looks natural. Everyone is at least Grade 1 as everyone has a capsule form. If it starts shrinking/contracting, the implant will feel more firm going from a grade 2 to grade 4, grade 4 being the most severe, causing pain and distortion.
The cause of capsular contracture is still not clear. It is believed that infection, hematoma or a seroma may put a woman at greater risk. Some women may develop a capsular contracture for no known reason.
Studies have shown that massaging seems to reduce the likelihood of forming a capsular contracture. Dr. Delgado will give detailed instructions on how to do this at the first post operative appointment usually three days after surgery. The exercises are to be done hourly for three months and then daily.