Can periaereola approach be done without touching the implant?

I've read a few posts on making sure to keep the implant as clean as possible prior to being put into the body. I saw a video using the funnel/no touch in the bottom of the breast fold and then saw a video of a surgeon stuffing the implant through the nipple. Is that how they have to be inserted? If so, does that lead to more possibilities for infection or capsular contracture?

Doctor Answers 9

Can a peri areolar incision be used with a limited touch technique for augmentation?

Thanks for the question.  I must say that this incision can certainly be used with a limited touch technique using a Keller funnel, but some of the benefit  can be lost  when the surgeon still has to gently manipulate the implant into a proper position once it is below the skins entry level and is in the pocket.  It is known that there is a higher likelihood for overall breast implant contamination with bacteria with entry through the periareolar incision  versus the more sterile entry through an inframammary incision.  I have certainly seen this to be true in my practice over the years.  Be aware that there is a benefit to using the inframammary incision over all other techniques when attempting to minimize the  chance of developing a capsular contracture because of bacterial contamination, whether a Keller funnel is used or not.
Good luck to you.
Frank Rieger M.D. Tampa Plastic Surgeon

Can periareolar approach be done without touching the implant?

Thank you for doing your research and asking an excellent question.  Implants can be placed through 4 approaches - breast crease, periareolar, armpit, and belly button - with the first two the most common.  The Keller funnel can be used to place the implant through the areolar incision which minimizes the risk of any bacterial contamination to the implant from a woman's milk ducts, possibly reducing capsular contracture risk. Hope this helps.

Nelson Castillo, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 68 reviews

No touch technique through the areolar approach

The Keller funnel can be used to insert silicone implants through inframammary, transaxillary, or periareolar incision locations.   The funnel makes it much easier to place the implants. There is less manipulation of the implant and it does not touch the skin when it is going in.  Even when using the funnel however, the implants are typically touched because the surgeon needs to manipulate them and ensure that they are in proper position after they go into the pocket. Best wishes to you!

Erik Miles, MD, FACS
Charlotte Plastic Surgeon
5.0 out of 5 stars 30 reviews

Can periaereola approach be done without touching the implant?

Thank you for the question. There are several good approaches to breast augmentation surgery; different surgeons will have their own preferences. In my practice, I prefer the inframammary or infrareolar approach for most patients. Yes, the implants can be inserted without touching the surgeon's hands or the patient's skin. Despite what you may hear, I think most patients can have the infraareolar incision used regardless of the size of breast implants or size of areola. The Keller funnel has made the insertion of all sizes of breast implants much easier. I think of the funnel has also made it easier to perform a true "no touch" technique ( potentially decreasing the incidence of breast implant encapsulation). Personally, I think the advantages of the infraareolar incision far outweigh any theoretical disadvantages. These advantages include proximity to the planned dual plane submuscular pocket dissection, relatively hidden/forgiving location of scarring, coverage by clothing/swimming suit etc. Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,499 reviews

No-touch technique

The no touch technique refers to the implant never touching your breast skin. It is normal foe bacteria to live on the skin. We using soapy prep solution to prepare the skin for surgery. This reduces the number of bacteria but does not sterilize the skin. Therefore it is still helpful to avoid touching the implant to the skin to further reduce the likelihood of infection.

Sheldon Lincenberg, MD
Atlanta Plastic Surgeon
4.7 out of 5 stars 26 reviews

No Touch Technique

Thank you for your question. A Keller Funnel used with a peri-areolar incision will minimize implant contact and contamination related to milk ducts. The Funnel can be used through other incision routes as well and allows for a "no-touch" technique, minimizing skin and implant manipulation. I recommend that you ask your Plastic Surgeon about this approach as many Plastic Surgeons prefer to use it.
All the best

Jerome Edelstein, MD
Toronto Plastic Surgeon
5.0 out of 5 stars 179 reviews

Can periareolar approach be done without touching the implant?

Yes.  By using the Keller funnel, the implant can be inserted into the breast pocket via a "no touch" technique through the periareolar incisional approach.  There is much less chance of complications using the Keller Funnel for "no touch" technique implant insertion versus not using this technique, particularly when inserting through the periareolar approach.

L. Dwight Baker, MD
Dothan Plastic Surgeon
4.6 out of 5 stars 35 reviews

Breast augmentation

The Keller funnel can be used to place the implants in the periareolar approach.  It does minimize the surgeon touching the implant, which in turn decreases the chance for a bacterial infection.  Be advised though that the implant almost always is touched at least to a minimal degree by the surgeon during placement.  There are many techniques utilized during surgery to minimize infection, such as the use of IV antibiotics.  You can check with your surgeon to see if he/she uses the funnel and ask about other strategies to minimize infection risk.

Camille Cash, MD
Houston Plastic Surgeon
4.8 out of 5 stars 33 reviews

No touch insertion of implants

Personally, I think the idea of avoiding contact with an implant no matter which incision is used is ridiculous.  Your breast ducts spread throughout your breast tissue and bacteria live in those breast ducts.  No matter which incision is used, it is hard to avoid some contact with skin, breast tissue, or the surgeon's gloved hands.  I have been doing lots of breast augmentations over the past twenty five years. I do handle the implants and I do like the peri-areolar approach.  I don't think I have any higher rates of contamination, capsular contracture, or infection than anyone who uses the no touch techniques.  I do like using the Keller funnel and I wish I had thought of it first because it certainly makes insertion of the implants a lot easier.

Edwin C. Pound, III, MD
Atlanta Plastic Surgeon
4.6 out of 5 stars 25 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.