Bresnick Stephen D
Private Practice, Los Angeles, Calif.
Plast Reconstr Surg Glob Open. 2021 Nov 2;9(11):e3906. doi: 10.1097/GOX.0000000000003906. eCollection 2021 Nov.
Breast implant insertion funnels have become popular adjuncts to breast implant surgery to reduce access incision length and contact of the implant with the skin of the breast. Although labeled as single-use devices, due to cost considerations, many surgeons use a new breast implant insertion funnel with each patient rather than each breast. The purpose of this study was to evaluate the prevalence of capsular contracture of the first augmentation side and compare it to the second side utilizing one insertion funnel per patient.
Patients undergoing silicone breast augmentation or silicone augmentation mastopexy with smooth surface silicone implant and utilizing a breast implant insertion funnel were studied. Six hundred consecutive patients (1200 breasts) meeting the study criteria were evaluated. Memory Gel silicone breast implants were utilized for each patient and only patients undergoing augmentation with the same implant size were studied. Patients underwent augmentation with either inframammary or periareolar incisions.
A total of 27 capsular contractures were noted, a rate of 2.25%. The rate of capsular contracture was significantly higher with the second-side use of insertion funnels ( = 0.0179). Of the capsular contractures noted, 25.9% occurred on the first side, whereas 74.1% occurred on the second side. Capsular contracture rates were higher on the second side for both access incision locations. Capsular contracture prevalence increased with reuse of the same insertion funnel for the same patient.
Based on these findings, surgeons should consider utilizing implant insertion devices as single-use, to minimize the capsular contracture risk.
乳房植入漏斗已成为乳房植入手术中常用的辅助工具，可减少切口长度并降低植入物与乳房皮肤的接触。尽管被标记为一次性使用器械，但出于成本考虑，许多外科医生在为每位患者手术时使用新的乳房植入漏斗，而非为每个乳房都使用新的。本研究的目的是评估首次隆胸侧包膜挛缩的发生率，并将其与每位患者使用一个植入漏斗的另一侧进行比较。
对接受硅胶乳房增大术或硅胶增大乳房上提术、使用表面光滑的硅胶植入物并使用乳房植入漏斗的患者进行研究。对连续600例符合研究标准的患者（1200个乳房）进行评估。每位患者均使用记忆凝胶硅胶乳房植入物，仅研究接受相同植入物尺寸增大术的患者。患者通过乳房下皱襞或乳晕周围切口进行增大术。
共发现27例包膜挛缩，发生率为2.25%。植入漏斗第二次使用时包膜挛缩率显著更高（=0.0179）。在发现的包膜挛缩病例中，25.9%发生在第一侧，而74.1%发生在第二侧。两个切口位置的第二侧包膜挛缩率均更高。同一患者重复使用相同的植入漏斗时，包膜挛缩发生率增加。
基于这些发现，外科医生应考虑将植入器械作为一次性使用，以将包膜挛缩风险降至最低。
