Safety of a Protective Funnel in Primary Breast Augmentation: A Retrospective Analysis of 380 Multicenter Cases in the United States.

BACKGROUND: Protective funnel devices are commonly used to deliver implants in primary breast augmentation (BA) yet there is a paucity of evidence-based data describing their safety in the literature. OBJECTIVES: The purpose of this study was to assess the safety of protective funnels in primary BA within the first 30 days postoperatively. METHODS: This multicenter, Level 3 study retrospectively reviewed the surgical records of 380 consecutive patients (760 breasts) who underwent primary BA by 9 board-certified plastic surgeons using the iNPLANT Funnel (Proximate Concepts LLC, Allendale, NJ) for implant delivery between November 2019 and December 2020. Data were collected pertaining to demographics, implant information, surgery details, and postoperative complications. RESULTS: The mean patient age was 33 years and 76% of patients had a BMI <25 kg/m2. Of this cohort, 11.4% were smokers, 0.8% had diabetes, and 83% were ASA Class 1. All patients received smooth implants with a median volume of 375 cc. A total of 8 (2.1%) complications were reported, including 3 hematomas (0.79%), 1 seroma (0.26%), and 1 superficial infection (0.26%). No patient required explantation. We identified ASA class, BMI, surgery duration, and implant size as potential risk factors. CONCLUSIONS: The data suggest that the use of protective funnels, such as the iNPLANT Funnel, in primary BA is a safe option when these are utilized according to the manufacturer's Instructions for Use. The use of this device led to a low infection rate (0.26%) and a complication rate of (2.1%) consistent with the average reported in the literature (2%-2.5%).1 Implications for clinical practice are encouraging and future research will include a prospective analysis with a larger case series and potentially a control group.

Reducing seroma in outpatient abdominoplasty: analysis of 516 consecutive cases.

BACKGROUND: Over the past 30 years, the preferred techniques and settings for abdominoplasty have evolved considerably, but controversy remains regarding the surgical and postoperative approaches that best limit serious complications such as seroma. OBJECTIVE: The authors evaluate their 28-year experience with abdominoplasty and suggest a technique (progressive tension sutures without placement of drains) for reducing the overall complication rate, most significantly with regard to seroma. METHODS: A retrospective review was conducted of 517 consecutive abdominoplasty cases in the senior author's clinic. The cases were divided into five groups based on operative setting, postoperative care, and surgical technique. Concurrent procedures and complications were also reviewed. RESULTS: The authors found that the last group of patients, in whom abdominoplasty with progressive tension sutures (but without drains) was performed as an outpatient procedure, had the lowest incidence of seroma. Specifically, the incidence of clinically significant seroma formation requiring aspiration was 9.6% in early groups, when abdominoplasty was performed as an inpatient procedure; the rate was 24% when it was performed as an outpatient procedure without the placement of progressive tension sutures, but was then reduced to 1.7% with the placement of progressive tension sutures and no drains. CONCLUSIONS: Abdominoplasty can be safely performed with other concomitant procedures (such as liposuction) in a strictly outpatient setting when surgical time is limited. Despite controversy in the previous literature, the authors' data support the conclusion that the placement of progressive tension sutures without drains dramatically decreases overall complication and seroma rate during abdominoplasty.