Sequential Advancement Method: A Funnel-Based Technique for Safe Placement of Small Breast Implants

Recent aesthetic trends in breast augmentation favor smaller implants and minimal-incision techniques. However, placement of very small implants (100-165 cc) may pose unique mechanical challenges during funnel-assisted insertion because of the smaller contact surface area available for force distribution. The Sequential Advancement Method (SAM) provides a simple and reproducible solution by placing a larger sizer behind the implant within a sterile funnel-based implant delivery device to distribute force more evenly. This technique enables safe prepectoral placement through 2 cm incisions, reducing peak pressure and lowering tissue trauma. Although larger cohort studies are needed to validate outcomes, SAM offers a biomechanically sound strategy to support patient aesthetic preferences while decreasing the risk of implant-related complications. Level of Evidence: 5 (Therapeutic).