Keller Funnel Efficacy in “No Touch” Breast Augmentation and Reconstruction: A Systematic Review
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 infec...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer
2022-11-01
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| Series: | Plastic and Reconstructive Surgery, Global Open |
| Online Access: | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000004676 |
| _version_ | 1811216660596523008 |
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| author | Suat Morkuzu, MD Mehmet Ozdemir, MD Garrison A. Leach, MD Muholan Kanapathy, MD, MRCS, PhD Afshin Mosahebi, FRCS(Plast), PhD, MBA Chris M. Reid, MD |
| author_facet | Suat Morkuzu, MD Mehmet Ozdemir, MD Garrison A. Leach, MD Muholan Kanapathy, MD, MRCS, PhD Afshin Mosahebi, FRCS(Plast), PhD, MBA Chris M. Reid, MD |
| author_sort | Suat Morkuzu, MD |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-04-12T06:43:06Z |
| format | Article |
| id | doaj.art-d99194d8bd044f8d82bfe73ab5a58f65 |
| institution | Directory Open Access Journal |
| issn | 2169-7574 |
| language | English |
| last_indexed | 2024-04-12T06:43:06Z |
| publishDate | 2022-11-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Plastic and Reconstructive Surgery, Global Open |
| spelling | doaj.art-d99194d8bd044f8d82bfe73ab5a58f652022-12-22T03:43:40ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742022-11-011011e467610.1097/GOX.0000000000004676202211000-00060Keller Funnel Efficacy in “No Touch” Breast Augmentation and Reconstruction: A Systematic ReviewSuat Morkuzu, MD0Mehmet Ozdemir, MD1Garrison A. Leach, MD2Muholan Kanapathy, MD, MRCS, PhD3Afshin Mosahebi, FRCS(Plast), PhD, MBA4Chris M. Reid, MD5From the * Institute for Reconstructive Surgery, Houston Methodist Hospital, Houston, Tex.† Department of Plastic and Reconstructive Surgery, Dicle University Hospital, Diyarbakir, Turkey‡ Division of Plastic Surgery, Department of Surgery, University of California, San Diego, San Diego, Calif.§ Department of Plastic Surgery, Royal Free Hospital; and Division of Surgery and Interventional Science, University College London, London, United Kingdom.§ Department of Plastic Surgery, Royal Free Hospital; and Division of Surgery and Interventional Science, University College London, London, United Kingdom.‡ Division of Plastic Surgery, Department of Surgery, University of California, San Diego, San Diego, Calif.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.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000004676 |
| spellingShingle | Suat Morkuzu, MD Mehmet Ozdemir, MD Garrison A. Leach, MD Muholan Kanapathy, MD, MRCS, PhD Afshin Mosahebi, FRCS(Plast), PhD, MBA Chris M. Reid, MD Keller Funnel Efficacy in “No Touch” Breast Augmentation and Reconstruction: A Systematic Review Plastic and Reconstructive Surgery, Global Open |
| title | Keller Funnel Efficacy in “No Touch” Breast Augmentation and Reconstruction: A Systematic Review |
| title_full | Keller Funnel Efficacy in “No Touch” Breast Augmentation and Reconstruction: A Systematic Review |
| title_fullStr | Keller Funnel Efficacy in “No Touch” Breast Augmentation and Reconstruction: A Systematic Review |
| title_full_unstemmed | Keller Funnel Efficacy in “No Touch” Breast Augmentation and Reconstruction: A Systematic Review |
| title_short | Keller Funnel Efficacy in “No Touch” Breast Augmentation and Reconstruction: A Systematic Review |
| title_sort | keller funnel efficacy in no touch breast augmentation and reconstruction a systematic review |
| url | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000004676 |
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