What is the Success Rate for Keller Pump for BA Revision?

I have a ruptured saline implant (475 o.f. 525cc) and will be switching to silicone. I interviewed 2 Dr's, and chose the dr that uses the Keller pump in conjunction with a mentor 550cc hp. When I informed the office for the dr that I did not chose, I was told that this was a far inferior surgical method and gave inferior results. I have a surgical date in 2 weeks and am now very concerned that I may not be fully informed on the safety of this method. Can anyone help? Thanks!

Doctor Answers (7)

Funnel

+2

The funnel has no bearing on the final result. It only facilitates the placement through a smaller incision and reduces the surgical time


New York Plastic Surgeon
5.0 out of 5 stars 9 reviews

Keller Funnel for Breast Implant Revision

+2

   The Keller funnel has very little if anything to do with the quality of the result.  There may a significant skill difference between two surgeons, but the Keller funnel will not be the difference.  Kenneth Hughes, MD Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 180 reviews

Keller Funnel?

+2

Some surgeons use this funnel to squeeze the implant into the pocket. In my opinion it does not add anything to the surgery.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 15 reviews

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Keller Funnel for Breast Augmentation Revision for Large Gel Implants

+2

I have no idea why you were told that the use of a Keller funnel would give inferior results. Perhaps we are confusing a device with a technique.  A Keller funnel  is a sophisticated low-tech device that allows the plastic surgeon to introduce a gel implant into the pocket through a smaller incision, with less tissue and implant trauma and less implant contact with skin and breast bacteria.

I remember the days of residency when we watched with admiration as the professor with great dexterity coaxed the resisting gel implant through the incision, little by little milking it through with fingers and thumbs flying until voila, it disappeared into the pocket.   Then in practice it was a gradually improving skill as I learned to do the same, trying to spare the patient any larger an incision than possible.  One soon learned with this method that if the incision was slightly too small, the implant simply would not go into the pocket. Stop, lengthen the incision, and only then would the implant go in.

Those days are over in my practice. I had always used a no touch technique, meaning, the implant was introduced with the use of new gloves that had touched nothing else, but that did not prevent contact, lots of it, between the implant and the skin.  A recent study determined that the bacterial colony count on the implant with and without use of the Keller funnel was something like twenty times lower when the funnel was used.

And since the main current theory of capsular contracture is bacterial colonization of the implant by skin or breast bacteria, it only reinforces my desire to use the funnel, which was primarily developed for ease of insertion and smaller incisions. 

If you have a relatively small incision because you had saline implants initially, which do not require a very long incision for implant placement and pocket dissection, you will be unable to put a 550 HP implant through it without significantly enlarging it.  Granted, you will still need a 4.25-5.0 cm incision even with a Keller funnel to put in a 550 HP gel implant, but it is smaller than what you would need if you did not use the funnel.

So I am still not sure about the "method" your other surgeon is describing as inferior, and it may be something unrelated, but this is the basic information about the Keller funnel.

Robert M. Lowen, MD
Mountain View Plastic Surgeon
5.0 out of 5 stars 26 reviews

What is the Success Rate for Keller Pump for BA Revision?

+2

I assume you are talking about a Keller funnel, which is a device that permits insertion of a silicone gel implants through a smaller incision, with less trauma to the implant, and with the use of a no-touch technique that probably reduced a number of potential complications  including infection and capsular contracture. I use it for all silicone implants. The only disadvantage is the cost--it adds about $100 to the procedure costs.

I can't begin to imagine a scenario is which someone could say that it produces inferior results. 

I should add that other than perhaps offering some protection against contracture, it does not affect otherwise the "success rate" of revision. The rest of the revision procedure, which will vary with the problem at hand, will not be changed--only the implant insertion technique. 

I would stick with the surgeon you chose! All the best. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.5 out of 5 stars 30 reviews

Keller Funnel and Breast Augmentation?

+2

Thank you for the question.

I use the Keller funnel for all  breast cases that involve the use of silicone gel breast implants. I have found it a useful tool that allows for easier insertion of silicone gel breast implants with less manipulation/contact  and (probably) the use of smaller incisions.

 I hope this helps.

 

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 681 reviews

Keller funnel in breast implant insertion

+2

I don't know what a Keller "pump" is but a Keller funnel is a fantastic device that allows the surgeon to place a gel implant with a "no touch" technique, perhaps a shorter scar, with less trauma to the implant and without it touching the bacteria on your skin (maybe less risk of capsular contracture).  I get no money from this company but would never stop using it!  Who ever told you it was "inferior" to poking the implant in with their fingers is wrong in my opinion.

Remember though that the Keller funnel is only a device to insert the implant.  It is not going to be the final determinant of the revision result.  That will depend on what the problem is, the quality of your own tissues, your expectations and the skill and training of your surgeon.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
5.0 out of 5 stars 47 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.