have any of you done a saline 480cc implnat exchange through the armpit putting a 650cc silicone implant in using the keller funnel// Can this be done?
Can a Transauxillary Implant Exchange Be Done Using a Keller Funnel?
Doctor Answers 7
the pocket needs to be developed properly prior to the placement of the implant. the funnel can be used for the placement of these implants through smaller incisions
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Breast Augmentation through Axilla (arm pit)
Large implants through the armpit approach
I personally do not do augmentations through the axilla. The other doctor's opinions suggest this size implant would be difficult to place as the incision will be close to 5.5-6 cm. The Keller Funnel does facilitate placement of gel implants so if your incision can be made long enough in the axilla, you should be able to have it done that way. However, I can assure you that none of my patients have ever complained about their areola or inframammary scars.
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Is Breast Implant Exchange A Good Idea Through The Axilla With The Keller Funnel?
A 650cc silicone breast implant can be put in through the axilla with a Keller Funnel. It is not the best way to put in such a large implant but it can be technically done. The more important question is in doing this exchange does your implant pocket need to be modified in any way to accomodate the bigger implant. (I suspect that it might) If so, then a lower fold approach is going to be better as it will be virtually impossible to modify the pocket once the new implant is put in through the transaxillary approach.
Implant exchange via transaxillary approach
An implant exchange may be quite difficult to achieve through a limited incision transaxillary approach expecially if you have to deal with removing a capsule. The keller funnel is only a device to insert the implant.
Limits of a transaxillary incision
There are limits of revision from the axilla and this includes what you can do to the pockets as well as the size of the implant you can put in without the scar becoming too big. A 650 gel implant even with the Keller funnel will need a much longer incision than the one you already probably have so you should really consider whether an IM crease at this point might just be better.
It is possible, the question is what would be best for you.
Thank you for the question. The 650 cc implant is rather large for trans-axillary placement but it can be done. Going from 480 saline to 650 silicone will require pocket modification and may also benefit from the use of an intra-operative sizer to verify symmetry and proper pocket modification. Placing the sizer through the axilla using a Keller funnel can be done as well but taking it out to place the final implant will be difficult. You will have to consider these issues when deciding whether to proceed with trans-axillary approach or whether an infra-mammary (breast fold) incision should be used.
All the best,
Dr Remus Repta
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