Keller Funnel (No-Touch Implant Insertion)

What is the Keller Funnel?

The Keller Funnel is a single-use medical device designed to help a surgeon place a silicone gel breast implant into its pocket. It looks like a flexible, transparent cone, similar in shape to an icing bag. The inside is coated with a hydrophilic layer that becomes very slippery when the funnel is soaked in sterile solution. The implant is loaded into the wide end and gently propelled out of the narrow end, through the incision and into the pocket that has been prepared for it.

The idea behind it is simple: the implant should travel from its sterile package to its final position with as little handling as possible and without rubbing against the patient’s skin. This is often called no-touch insertion.

How does no-touch insertion work?

The manufacturer describes four steps, which reflect how the funnel is used in theatre:

• Trim. The narrow end is cut to an opening sized for the specific implant, so that it can pass through gently.
• Hydrate. The funnel is immersed in sterile saline, which activates the slippery inner coating.
• Load. The implant is placed into the wide end of the funnel directly from its sterile packaging.
• Propel. With the tissues retracted, the narrow end is placed at the opening of the pocket and the implant is guided into place with gentle pressure on the funnel, not on the implant. The funnel is then removed.

The implant does not touch the skin edges of the incision, and it is compressed evenly as it passes through the funnel rather than being squeezed by fingers through a small opening.

Why does reducing contact with the skin matter?

Capsular contracture, in which the scar capsule around an implant tightens and hardens, is one of the most common reasons for breast implant revision. Its causes are not fully understood, but one leading theory is that low-grade bacterial contamination of the implant surface at the time of surgery can lead to a biofilm, a thin layer of bacteria that triggers chronic inflammation and capsule thickening. The skin and the ducts of the nipple naturally carry bacteria even after antiseptic preparation.

Reducing the implant’s contact with the skin is therefore a logical step. No-touch insertion is part of a wider philosophy that also includes sterile theatre standards, minimal handling of the implant, careful control of bleeding and the choice of incision. Dr. Paulo Michels prefers the inframammary-fold incision, placed in the crease under the breast.

What does the evidence say?

This is where honesty matters, because the funnel is often marketed with more confidence than the science supports.

• Studies in favour. A multicentre report in the Aesthetic Surgery Journal compared surgeons’ results before and after they adopted the funnel and found fewer revisions for capsular contracture after its introduction. Other, mostly retrospective, studies have reported lower contracture rates, shorter incisions and faster insertion with the funnel.
• A systematic review. A systematic review published in Plastic and Reconstructive Surgery Global Open concluded that the funnel was associated with a lower capsular contracture rate, shorter incisions and easier insertion. The authors also noted that the studies were mostly retrospective, that no randomised controlled trials existed, and that the medium- to long-term effect still had to be proven.
• Critical views. Other authors have challenged the evidence, arguing that the supportive studies were confounded, had limited follow-up and involved financial conflicts of interest, and that the clearest proven benefit is a modestly shorter incision.
• Ongoing review. A Cochrane systematic review on insertion funnels for preventing capsular contracture has been registered, which reflects that the question is still considered open.

The fair summary is that published studies have associated funnel use with lower capsular contracture rates, the device clearly allows gentle, minimal-contact insertion, and the evidence is encouraging but not conclusive. The funnel is a sensible part of a careful technique, not a guarantee.

Claimed benefit	What can fairly be said
Less contact between implant and skin	Yes, this is the purpose of the design
Lower capsular contracture	Associated in several studies; not proven by randomised trials
Shorter incision	Supported, though the difference depends on implant size
Gentler insertion, less stress on the implant	Consistent with the design when used as instructed
Eliminates infection or contracture	No; no device can do this

How does Dr. Paulo Michels use the Keller Funnel?

In breast augmentation, the Keller Funnel is part of Dr. Paulo Michels’ standard technique — used in every operation in which he places an implant — for no-touch insertion of cohesive silicone implants from Motiva, Mentor or Polytech, with smooth or nano-textured surfaces preferred. It works together with the other elements of his approach:

• the inframammary-fold incision, hidden in the breast crease;
• Dual Plane placement as standard;
• the Internal Bra principle, with permanent sutures reinforcing the breast fold to support the implant over time;
• ultrasound-guided nerve blocks for comfort;
• skin closure with cyanoacrylate surgical glue.

The same applies when an implant is placed as part of a breast lift with implants or exchanged during revision: every implant Dr. Michels inserts goes in through the funnel.

Is the funnel right for every patient?

The funnel is a method of delivering a silicone implant, so it is relevant to any operation in which one is inserted: a first augmentation, a lift with implants, or an implant exchange during revision. It does not influence which implant suits you, which pocket is right, or whether you need a lift; those decisions come from examination and measurement at the consultation.

What the funnel does change is how the implant is handled in the final moments of the operation. Instead of being pressed through the incision by hand, the implant is compressed evenly and guided into place, which is gentler and keeps it away from the skin edges. In revision surgery, many other factors matter more to the outcome, such as the condition of the capsule, whether a capsulectomy is needed and how the pocket is repaired, so the funnel is a detail within a larger plan. See capsular contracture and breast implant revision.

What are the limitations?

• The funnel does not change the risks of the operation itself: bleeding, infection, capsular contracture, changes in nipple sensation, asymmetry, rippling and malposition all remain possible. See breast implant rippling and bottoming out and implant malposition.
• It is designed for silicone gel implants.
• It is labelled for single patient use and must not be re-sterilised or reused. One study reported a higher contracture rate on the second side when one funnel was used for both breasts, and some authors recommend one funnel per breast.
• Incision length still depends on implant size and type.

What does recovery look like?

Using a funnel does not change the recovery plan. After augmentation you can expect light walking from the first day, sleeping on your back for 4 to 6 weeks, a support bra for 4 to 6 weeks and no high-impact exercise or upper-body weights for 4 to 6 weeks. The week-by-week detail is in breast augmentation recovery.

How is implant insertion discussed at the consultation?

At the consultation in Abu Dhabi, Dr. Paulo Michels, a Brazilian board-certified plastic surgeon with more than 18 years’ experience, explains the whole surgical plan: implant brand, size and profile chosen from your measurements, with the Crisalix 3D simulation to compare options, the incision, the pocket, Internal Bra support and the no-touch insertion. You are welcome to ask about any step, including how the funnel is used.

Surgery takes place at Elyzee Hospital in Abu Dhabi, a fully licensed private hospital, where patients from Dubai and across the UAE are seen, with visits grouped to reduce travel. Consultations are available in English, Portuguese or Spanish. Send a WhatsApp message to +971 50 106 7981 to arrange yours; an individual quote follows the consultation.