Continuing our series on Capsular Contractures after breast implants in Honolulu, the #2 way or the second most common way to create hard breasts after a breast augmentation is for the surgeon to allow non-pathogenic bacteria (i.e. skin bacteria) to get into the capsular pocket around a breast implant.
Up until a few years ago, the only way to get a silicone breast implant into a pocket, through the armpit, through the edge of the nipple areolar complex, or through an inframammary incision was to have the surgical assistant hold the pocket open while the surgeon pushed the implant in, potentially dragging non-pathogenic skin bacteria into the pocket. This bacteria we have lived with in a symbiotic relationship all our lives and they cause minimal to no infection, but they look to our immune system like a pathogenic bacteria. Therefore, the body releases an immunoglobulin to protect us against this invader, and while walling off the non-pathogenic bacteria, the immunoglobulin (our immune system) also walls off or increases the capsule around a breast implant leading to hard breasts.
A few years ago, Dr. Kellar devised a funnel, looking very much like a cake decorating funnel, which could be adjusted to any implant size and could be sterially dropped form the implant box into a sterile funnel with the mouth of the funnel placed inside the incision allowing the implant to be placed in the pocket using a “no touch” technique. If the pocket was sufficiently lavaged (washed out) prior to the implant placement, minimal to no non-pathogenic bacteria get into the pocket.
Therefore, the Kellar funnel has decreased the chance of capsular contracture significantly. In a recent survey requested by the Kellar funnel people, my nurse discovered that we had a 50% decrease in capsular contractures secondary to the use of a Kellar funnel. The Kellar funnel also allows the surgeon to place a large implant in the implant pocket through a small incision due to the malleable nature of Honolulu silicone breast implants.
Post-operatively, in my practice at the Breast Implant Center of Hawaii, I also place all my Honolulu breast implant patients on a regiment of 90 days of oral leukotriene receptor antagonists. This prophylactic treatment, in my opinion, modulates the immune system allowing the breasts to remain soft by decreasing those immune factors which can cause capsular contracture, i.e. we get your early post-operative breasts into a steady state of softness that should continue unless outside influence intervenes.
