I have seen this procedure on television, but with the consultations I've had with doctors, no one really seems to want to do it. Is there a reason why? I know the best incision option for me would be through the areola since one of mine is larger than the other and that could be corrected at the same time. But if it wasn't for that, I would want to go through the belly button due to no detectable scarring. Why is this procedure not as popular?
Breast Augmentation Through the Belly Button?
Doctor Answers (32)
TUBA - Breast Augmentation Through the Belly Button?
Recent advances in instrumentation make it possible to perform the operation placing the implant either above or below the muscle. As there is no cutting of tissue over the ribs, patients experience much less pain and quicker recovery – even with placement under the muscle. The TUBA procedure requires a higher level of skill and training, which is why most plastic surgeons do not perform it.
Breast Augmentation Placement
There are several ways to place the incision so that it is well hidden in natural skin folds or breast transitions.
- a.Hidden at the natural transition from the areola and the breast skin. The incision can be hidden in this natural color transition
- 2.Inframmary Fold
- a.The incision is hidden in the fold below the breast.
- a.The incision for the implant can be hidden in one of the natural axilla folds.
- a.This technique has become less popular as only saline implants can be place using this method.
- b.Also patients run the risk of destroying the fold, which can cause their implant to drop overtime.
It is important to see your board certified plastic surgeon to help guide you to an implant that will give you an aesthetically pleasing breast.
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Breast Augmentation: Transumbilical Augmentation Vs. Transaxillary Infra-Mammary or Peri Areolar Incisions
The transumbilical approach to breast augmentation has advocates, but the vast majority of plastic surgeons prefer other surgical approaches. Surgeons, who prefer the transumbilical approach, feel that this procedure has the major advantage, of less scarring. They believe that transumbilical incisions heal imperceptibly. They acknowledge that there’s a steep learning curve with this procedure and that there are potential problems with implant malposition. There’s no question that excellent results can be obtained with this procedure.
The majority of plastic surgeons prefer the transaxillary infra-mammary or peri areolar incisions. They feel that these incisions are associated with a decreased incidence of implant malposition. They also feel that scarring with these incisions is rarely a problem.
They feel that the probability of implant malposition with transumbilical incisions is higher than the probability of adverse scarring with traditional breast augmentation incisions.
It’s important to realize that surgeons have different comfort levels with different incisions. They do their best work when they are able to use their preferred incision. Although good results can be obtained with transumbilical incisions there’s probably a good reason why the majority of plastic surgeons prefer traditional surgical approaches.
Not everyone is an expert
The issue with Trans-umbilical Breast Augmentation is that since its done almost "blind", most surgeons are too afraid to even attempt it. It requires a degree of skills that only a few doctors in the world have, including my good colleague Dr. Hasan who created and pioneered the procedure. The procedure is done blind and the measurements are very difficult to manage. Most doctors avoid it our of fear or lack of skills.
Popularity of TUBA
I have been doing the TUBA procedure for over twenty years now on patients from all over the world. The results are excellent in the right hands. As you read through the responses to this question, you will see a lot of negative things written about the TUBA procedure. I think these doctors have either never done a TUBA procedure or have never seen one done. I have had many doctors come to observe me do this procedure and they all leave the O.R. shaking their heads at how easy this procedure is. Why isn't this procedure more popular with doctors? I have several theories: 1. Doctors tend to be trained in one or two approaches for breast augmentation. They become comfortable with that approach and don't want to try anything new. They also don't want to lose patients to doctors who DO perform the TUBA so they simply downplay this approach. 2. Despite the fact that the TUBA approach utilizes well-established concepts that have been around since the 1970's, the doctor who specifically developed the TUBA approach is not a board-certified plastic surgeon so the community of plastic surgeons tends to dismiss his idea outright without ever giving it a chance. If someone in the hierarchy of plastic surgery had developed this idea, I can guarantee you that EVERYONE would be using this approach. 3. Because most plastic surgeons tend to ignore this approach, the door is open for "cosmetic surgeons" who get their training from weekend courses to exploit this approach for their own use. Because they are poorly trained, the risk of bad outcomes is greater. When bad outcomes occur, mainstream plastic surgeons can point and say that it is a bad procedure, not that there are poorly-trained doctors performing the procedure.
Again, as with any procedure, IN THE RIGHT HANDS, this is an excellent approach to putting in saline breast implants either above of below the chest muscle.
Breast augmentation through the belly button is not very popular.
TUBA is one of 4 main access incisions used for breast augmentation but is by far the most infrequently performed. If you are absolutely decided on TUBA then please seek out a plastic surgeon that performs a high volume of that particular procedure because There is a VERY steep learning curve. If you go to a surgeon that only performs 30-40 a year you will still be one of the patients he/she is learning on.
By no means do I want to try to persuade you if you are absolutely convinced that TUBA is what you want, but you have to understand that you have to have saline implants -- silicone is NOT an option. You also tend to have a longer recovery because you have a much larger area of tissue trauma (all the way from your belly button to your collar bones). Most if not all of the procedure is performed with a tissue expander which separates the tissue bluntly and can lead to significant bleeding and tissue trauma. You also have a higher chance of malpositioning (asymmetry).
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.