The placement of large custom implants in the testicular enhancement patient will pose challenges through the smaller midline scrotal incisions used. When looking at the implant diameter:incisional length ratio it usually almost two to one. And while scrotal skin is very elastic and ultrasoft silicone testicle implants very compressible it can still be a challenge to deform the implant enough manually to get it to pass through the incision. While extending the incisional length can be done and it is not inappropriate to do so I prefer to have a small incision as possible. This is best incision location to heal being exposed to frictional sheering forces between the legs and the pressure of the implants on it.
In changing the shape of the testicle implant to pass through an incision less in length than the diameter of the implant we can turn to a similar aesthetic implant problem…breast implants. This need to do exactly that has long been solved by the funnel insertion device. Shape like a confectioner’s funnel it’s smooth inner lining allows the implant to be extruded through the narrow opening at its end. It works by compressing the implant shape in a controlled fashion so it is equally deformed along its length to the size of the aperture as it moves through it. While a testicle implant does not have the exact hemispherical shape as that of a breast implant its oblong egg shape still works perfectly for the funnel device concept.
The implant is inserted into the funnel device and pushed to the small opening at its narrow end.The plastic funnel behind it is rolled tightly up against the implant. The end of the funnel is inserted into the scrotal incision.
Once the end of the funnel is inside the incision a final twist on it propels the implant through the end of the funnel into the dissected scrotal pocket.
The funnel device is used for numerous aesthetic implant placements including breast, buttock and pectoral implants. It works best in implant shapes that have either round, spherical or oblong shapes. The testicle implant fits into these type of shapes and there is no reason to not expect it to work as well for these much smaller implants as well. It also has one other advantage which is that it allows the implant to be placed with a ‘no touch’ technique.
Dr. Barry Eppley
World-Renowned Plastic Surgeon