Can a Transauxillary Implant Exchange Be Done Using a Keller Funnel?

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?

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

New York Plastic Surgeon
4.9 out of 5 stars 14 reviews

Breast Augmentation through Axilla (arm pit)

Breast Augmentation through axillary approach is a good technique in some patients. But for patients that require significant adjustment of breast implant pocket it might not be the best approach. This includes patients that are quite asymmetrical and some patients undergoing revision surgery. Placing a very large implant through the arm pit can be done in most patients. The Keller funnel is a device that facilitates insertion of the implants, and is not a determining factor if a particular patient is a good candidate for Transaxillary breast augmentation

Boris M. Ackerman, MD
Newport Beach Plastic Surgeon
4.7 out of 5 stars 57 reviews

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.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

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.

Barry L. Eppley, MD, DMD
Indianapolis Plastic Surgeon
4.7 out of 5 stars 72 reviews

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.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

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.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 67 reviews

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

Remus Repta, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 166 reviews

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