Devil’s Advocate: Evidence-Based Recommendation for “One Breast - One Insertion Funnel” Policy
Paolo Montemurro, Tarush Gupta- General Medicine
- Surgery
Abstract
Background
Ever since plastic surgeons routinely started using the insertion funnel, the rates of capsular contracture have reduced significantly. However, due to financial constraints, the same funnel is usually used for implantation of both sides.
Objectives
To find out whether the risk of capsular contracture is higher on the second breast, when using the single insertion funnel on both breasts.
Methods
The authors sent a sample of the insertion funnel’s tip right after taking it out of the sterile package and another sample of the tip after the funnel had been used to insert the first implant. These samples were sent for microbiological culture evaluations. Then, they retrospectively analyzed the capsular contracture rates in the first implanted breast vs the second implanted breast since we started using the insertion funnel routinely for breast augmentation.
Results
All the first samples of the funnel, (ie, those that were taken from the funnel before first implantation), showed no bacterial growth. At the same time, all the second samples (ie, those taken from the funnel after first implantation) had an organism growth (eight were positive for Staphylococcus epidermidis and two for Cutibacterium acne). Retrospective analysis of our results revealed the overall capsular contracture rate had reduced since the authors started using the insertion funnel. Moreover, this complication was still more common on the second implanted breast.
Conclusions
Surgeons could consider the use of 2 separate insertion funnels for implantation on each breast. This might help to slightly reduce the incidence of capsular contracture of each single breast.