Background: The Keller Funnel facilitates breast implant placement while minimizing contamination and capsular contracture risk. Antiseptic agents are commonly used as lubricants, but they may carry adverse effects. This study evaluated outcomes of funnel-assisted insertion lubricated with hyaluronic acid compared with manual insertion. Methods: A retrospective cohort study was conducted on 200 patients undergoing primary breast augmentation (2022–2024). Data were collected from the records of 100 patients who received manual implant insertion and 100 patients who underwent implant placement using the funnel technique. Demographics, surgical variables, scar size, insertion time, complications, and patient satisfaction (BODY-Q) were analyzed. Statistical significance was set at a P value of less than 0.05. Results: Mean patient age was 25.3 years, body mass index was 21.8 kg/m 2 , and implant volume was 330 mL. Scar size was smaller in the funnel group (32 versus 37 mm, P = 0.025). Insertion time was shorter (5.9 versus 57.6 s, P = 0.001). Complications occurred in 1% of funnel cases versus 8% of manual cases (odds ratio: 0.11; 95% confidence interval: 0.01–0.94; P = 0.04). Satisfaction improved significantly postoperatively in both groups (preoperative 54.3 versus 92.6 at 6 mo, P < 0.001) with no between-group difference ( P = 0.712). Conclusions: Funnel insertion with hyaluronic acid reduced scar size, insertion time, and complication risk compared with manual insertion, while achieving high and comparable satisfaction. This technique offers a safe “no-touch” alternative that may lower contamination and capsular contracture risk. Prospective studies are needed to validate long-term efficacy and to compare hyaluronic acid with antiseptic additives.
Hernández et al. (Sun,) studied this question.