Transaxillary and Use of Keller Funnel with Silicone Implants. Is This For Me? Will it Look and Feel Natural? (photo)

Hi I am looking to get silicone implants ( no more than 330 ccs). I would like to have it through the armpit and under the muscle. There a few doctor that have experience with this method but its what I want( very hard to find). Will this feel and look natural too? maybe I'm aiming for the sky but this is the ideal results I would like. I kind of want low placement and my breast to droop/sag/move like real one. (I know its what most people may way but i think this might be best?)

Doctor Answers 8

Transaxillary Breast Augmentation and Use of Keller Funnel with Silicone Breast Implants.

The Keller Funnel is a significant advance in breast augmentation. Using the Keller Funnel makes implant insertion easier, reduces contamination of the implant, and lessens the trauma to the implant, reducing the chance of implant rupture.

Be aware that some studies have shown that placing the implant through the axillary incision has a greater risk of complications than using the inframammary incision underneath the breast.

In particular it is more difficult to place the implant lower into the sagging breast using the axillary incision. If you are borderline needing a breast lift you may need a subglandular implant placed through the inframammary incision.

For more information on the Keller Funnel please read the link below:


The funnel is a great technique for inserting all implants including the anatomic, textured and gel forms through smaller incisions

Norman Bakshandeh, MD, FACS
New York Plastic Surgeon
4.9 out of 5 stars 14 reviews

Cohesive Gel Implants Through the Axilla (Arm Pit Incision)

The Keller funnel has made insertion of cohesive gel implants much easier and safer. In the past, we used to say that cohesive gel implants required a larger incision than saline implants because the implants come pre-filled as opposed to saline which we fill in the patient. However with the Keller funnel cohesive gel implants can now be inserted with an incision as small as a saline implant. This allows us to insert cohesive gel implants through tiny incisions under the breast, around the nipple or even through the axilla (armpit). 

Another advantages of the Keller funnel is that it reduces damage to the implant thus possibly increasing the lifespan of your implant. However the most important reason for using a Keller funnel is that it allows us to insert the implant using a "no touch" technique. When the funnel is used, the implant is protected from touching the skin. This reduces contamination of the implant from skin bacteria thus reducing the risk of capsular contracture or hardening of the breast.

At The Plastic Surgery Clinic we use the Keller funnel whenever we insert a cohesive gel implant. We are also one of the only Clinics in Canada where cohesive gel implants can be inserted through the armpit. This give the patient a natural looking breast without any visible scarring. 

Frank Lista, MD
Toronto Plastic Surgeon
4.5 out of 5 stars 111 reviews

Transaxillary bba and Keller funnel

Keller funnel helps to place a silicone implant through the transaxillary incision.  At 330 you don't even need the funnel.  I usually need it when the implants reach 400 cc.

I have performed many transaxillary augmentations with silicone implants and love the results.  However, patient selection is very important.  Your pictures show breasts that are droopy.  I would examine you more closely first to ensure that a transaxillary approach can position the implants well enough in someone like you.  My recommendation (even though I am a big fan of the transaxillary approach) is to consider a periareolar approach which would likely leave a scar that is no more visible or bigger that the one through the armpit.


martin Jugenburg, MD, FRCSC

Toronto Cosmetic Surgery Institute

Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 458 reviews

Keller Funnel and transaxillary Breast AUgmentation - Excellent Technique

This is a good technique, using the Keller Funnel to insert the breasts implant under the muscle via an endoscopic axillary approach, of which I have done over 1000.   See the referenced video to see this technique performed in under 10 minutes, skin to skin.

Daniel Del Vecchio, MD
Boston Plastic Surgeon
4.5 out of 5 stars 179 reviews

Implants and transaxillary approach

I do not like the transaxillary approach because they have the highest risk of implants malposition.  The keller funnel is used to limit the size of the incision.

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

Breast augmentation transaxillary with Keller Funnel

Transaxillary breast augmentation with Keller funnel is a good procedure in the right patient. For you, however, I would recommend areolar reduction and lift to address the assymetrical position of your nipples.  Implants can be placed though this incision partially under the muscle. This will give you the best final outcome in my opinion. 

Kevin Tehrani, MD, FACS
New York Plastic Surgeon
4.8 out of 5 stars 95 reviews

Transaxillary is an excellent chooice for augmentation

It should not be hard to find a surgeon who will use a transaxillary approach for augmentation, with or without a Keller funnel. The technique will give a very nice result and keep the scar off the breast. It is not too much to ask. You goal photo it not far off the from what you might be.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 42 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.