Higher Prevalence of Capsular Contracture with Second-side Use of Breast Implant Insertion Funnels

Breast implant insertion funnels have become popular adjuncts to breast implant surgery to reduce access incision length and contact of the implant with the skin of the breast. Although labeled as single-use devices, due to cost considerations, many surgeons use a new breast implant insertion funnel with each patient rather than each breast. The purpose of this study was to evaluate the prevalence of capsular contracture of the first augmentation side and compare it to the second side utilizing one insertion funnel per patient.

Patients undergoing silicone breast augmentation or silicone augmentation mastopexy with smooth surface silicone implant and utilizing a breast implant insertion funnel were studied. Six hundred consecutive patients (1200 breasts) meeting the study criteria were evaluated. Memory Gel silicone breast implants were utilized for each patient and only patients undergoing augmentation with the same implant size were studied. Patients underwent augmentation with either inframammary or periareolar incisions.

A total of 27 capsular contractures were noted, a rate of 2.25%. The rate of capsular contracture was significantly higher with the second-side use of insertion funnels (P = 0.0179). Of the capsular contractures noted, 25.9% occurred on the first side, whereas 74.1% occurred on the second side. Capsular contracture rates were higher on the second side for both access incision locations. Capsular contracture prevalence increased with reuse of the same insertion funnel for the same patient.

Based on these findings, surgeons should consider utilizing implant insertion devices as single-use, to minimize the capsular contracture risk.