Does Implant Insertion with a Funnel Decrease Capsular Contracture? A Preliminary Report

Aesthet Surg J. 2016 May;36(5):550-6. doi: 10.1093/asj/sjv237. Epub 2015 Dec 15.


Background: Capsular contracture remains a common and dreaded complication of breast augmentation. The etiology of capsular contracture is believed to be multi-factorial, and its causes may include biofilm formation due to implant/pocket contamination with skin flora. It has been shown that insertion funnel use reduces skin contact and potential contamination by 27-fold in a cadaver model. After incorporating the funnel into our surgical protocols, we anecdotally believed we were experiencing fewer capsular contractures in our augmentation practices.

Objectives: The purpose of this study was to test the hypothesis that capsular contracture related reoperation rates decreased after insertion funnel adoption using data from multiple practices.

Methods: At seven participating centers, we retrospectively reviewed the surgical records from March 2006 to December 2012 for female patients who had undergone primary breast augmentation with silicone gel implants. Group 1 consisted of consecutive augmentations done without the insertion funnel, and Group 2 consisted of consecutive augmentations done with the insertion funnel. The primary outcome variable was development of grade III or IV capsular contracture that led to reoperation within 12 months.

Results: A total of 1177 breast augmentations met inclusion criteria for Group 1 and 1620 breast augmentations for Group 2. The rate of reoperation due to capsular contracture was higher without use of the insertion funnel (1.49%), compared to Group 2 with funnel use (0.68%), a 54% reduction (P = 0.004).

Conclusions: The insertion funnel group experienced a statistically significant reduction in the incidence of reoperations performed due to capsular contracture within 12 months of primary breast augmentation.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Breast Implantation / adverse effects
  • Breast Implantation / instrumentation*
  • Breast Implantation / methods
  • Breast Implants / adverse effects*
  • Female
  • Humans
  • Implant Capsular Contracture / epidemiology*
  • Implant Capsular Contracture / etiology
  • Incidence
  • Reoperation / statistics & numerical data
  • Retrospective Studies
  • Silicone Gels / adverse effects*


  • Silicone Gels