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TUBA Breast Augmentation

asked 2 years ago by Meeko in san jose
Latest answer by David E. Kim, MD
Question viewed 6,567 times
Tags: TUBA

I want to do a Transumbilical (TUBA) Breast augmentation. Can use you TUBA procedure to put the implants under the muscle?

48 answers to TUBA Breast Augmentation

+4

TUBA: under or over the muscle

Hello, Yes, TUBA breast augmentation can be performed under the muscle. TUBA is designed to use saline implants since silicone implants would be essentially impossible to place via the belly button. When saline implants are placed, regardless of the incision used, they should be placed under the muscle for the best result. The benefit of the TUBA is that there is a small incision and it is in the belly button. The negative is that the TUBA procedure offers the... more
Remus Repta, MD

Phoenix Plastic Surgeon

www.aaaplasticsurgery.com

+3

Umbilical Breast Augmentation Great Method in Experienced Hands

Yes, you can place saline implants with an umbilcal approach under the muscle. And yes, the placement can be done accurately. The vase majority of doctors who claim that you cannot have accurate placement have not even done one breast augmentation with the umbilcal technique. So of course if you don't have experience it would be difficult. All the methods are good for placing breast implants including umbilical and trans- axillary. But if your doctor gives you a million reasons why the... more
David E. Kim, MD

Beverly Hills Plastic Surgeon
+3

TUBA's attraction is no scar on the breasts. But a bad augmentation looks worse than no scar!

It should be clear from my colleagues' comments that TUBA is fraught with potential problems that usually occur more frequently than with other incision choices. I know well-trained, experienced, board-certified plastic surgeons who do this operation (TUBA), and do it well. But just because it is possible does not mean it is the best! The surgeons who do this operation can show you many patient photos that will impress you, making you think that perhaps this is indeed a good choice.... more
Richard H. Tholen, MD, FACS

Minneapolis Plastic Surgeon
+3

With difficulty and only with saline

In my practice, I had the opportunity to operate at the same surgery center with Gerald Johnson,the plastic surgeon who developed TUBA ,and scrubbed with him on a few cases. The technique is primarily limited to sub mammary placement of saline implants. I never saw Gerald place the implants under the muscle. Although there are a few physician who describe sub muscular placement using the TUBA approach, I see more patients with malposition of the implants using this technique, than I have... more
Joseph M. Perlman, MD

Houston Plastic Surgeon
+2

It's possible... but I don't recommend it

In Medicine and Surgery, many techniques are possible. TUBA surgery is one of these. With this approach, it's very easy to have problems like malposition, asimmetries, inframmary fold irregularities,.... In other words, in my opinion you will achive a better result with other approaches (inframmamary/ periareolar preferably). I think that it's easier to get a better result after an augmentation mammoplasty (only with aesthetic purposes) using viscoelastic silicone gel... more
Enrique Etxeberria, MD

Spain Plastic Surgeon
+2

Yes to Subpectoral

Breast implants can be placed under the pectoralis muscle via the umbilical incision (TUBA). However, there are limitations to the TUBA approach. Because the incision size is small and located in a remote position, saline implants must be used, you cannot use silicone, it just won't fit. If you are very thin the path (tracts) from the umbilicus to the breast used to place the implants can develop noticeable scarring. Also, if you need to have your inframammary... more
David Finkle, MD

Omaha Plastic Surgeon
+2

TUBA

Implants placed by the TUBA procedure can be placed under or over the muscle, but are typically placed over the muscle. I have seen many patients with bad results after this procedure including implant malposition or implants just too tight in the pocket. In general, the only advantage is the scar. Often, using this procedure will void the warranty for your implant so I would definitely consider your alternatives. Scott Newman, MD FACS
Scott E. Newman, MD

New York Plastic Surgeon

www.psurgery.com

+2

Reconsider TUBA

TUBA (Trans-Umbilical Breast Augmentation) is not embraced by most plastic surgeons because there are specific additional risks unique to this approach, including improper implant positioning, either soon after surgery or developing over time. Before committing to this approach, consult a few plastic surgeons or read more about the complications on the Internet.
Paul C. Zwiebel, MD

Denver Plastic Surgeon
+2

TUBA Augment

TUBA in my opinion is not the way to go.I have seen several in my practice that looked terrible.Also you can't put silicone in which in my opinion is the best.Also you must check to see if the implant manufacturerwill provide a warranty using this approach.The majority of my augmentations are with the inframammary approach.
Robert Brueck, MD

Fort Myers Plastic Surgeon
+2

TUBA can put breast implants under the muscle through the belly button

TUBA (transumbilical breast aumentation) places breast implants through a tunnel from your belly button to the breast.  It can place the implants on top of the muscle, or with more difficulty, under the muscle.  I learned TUBA from the developer of the procedure, Dr Gerald Johnson.  I did numerous cases and can make the following generalizations.  Bleeding and positioning aren't usually problems,  There are size limitations with submuscular implants. ... more
Daryl K. Hoffman, MD

Los Gatos Plastic Surgeon
+1

TUBA an excellent procedure in the right patient

TUBA (Trans Umbilical Breast Augmentation) is a novel operation for placement of saline implants above or under the muscle. The ideal candidate for this procedure is any patient that would be a good saline candidate. The only two drawbacks of this procedure are" 1: limited to saline implants 2: a VERY steep learning curve An experirnced board certified plastic surgeon who has done many of these procedures can give you... more
Kevin Tehrani, MD, FACS

New York Plastic Surgeon

www.AristocratPS.com

+1

Transumbilical breast augmentation

Compared to other approaches for breast augmentation, the TUBA suffers from the following disadvantages: 1. The need for an alternative approach (incision) for revisionary surgery. 2. The need for a second incision when this is combined with any type of mastopexy, or breast lift. 3. It does not allow for the use of silicone gel implants. This significantly reduces the options a patient has, and increases the risk of implant rippling for those patients at risk for this... more
Glynn Bolitho, PhD, MD, FACS

San Diego Plastic Surgeon
+1

TUBA was designed for submammary implant placement

There are surgeons who report using this technique to place the implants under the muscle. the truth is, the further your incision is from the area that you are operating on, the less control you have. breast implant surgery is all about controlling the pocket. again, if you are operating from an incision far away from the breast, you have very little control. for those who desire breast augmentation under the muscle with an incision off of the breast, i would... more
Eric Chang, MD

Baltimore Plastic Surgeon

www.columbiaaesthetic.com

+1

Myths about TUBA dispelled

TUBA is a great operation for sub-muscular placement of saline implants in anatomically appropriate patients. It does have a steep learning curve and should not be universally used for all augmentation patients, any more than a transax (armpit), periareolar, or crease incision. Thin patients with good symmetry (yes, they exist) and no sagging are the best candidates. There are risks, as with any proceedure, but in the hands of an experienced surgeon, the results are... more
Christopher J. Schaffer, MD

Birmingham Plastic Surgeon
+1

Avoid the TUBA , use transaxiallry for beautiful results

I would strongly recommend staying away from TUBA. The reality is that in very experienced hands the implant may be above, partially through in or under the muscle. Only saline implants are placed which means for these two reasons your breasts will not be ideal and with the limited control the surgeon has, partially up to cahnce. TUBA can be a reasonable choice for a patient with perfect breast, nipple and chest wall morphology, but these patients are rare. To get a... more
Rian Maercks, MD

Miami Plastic Surgeon
+1

Breast Augmentation through the belly button

TUBA has been performed for a number of years now and has its limitations like all surgeries do. First is that experience is needed to get good at that procedure, so best to go to someone that has done a large number of them. Secondly, there are many reports in the medical literature of ridges or tracks of firm tissue developing going from the belly button to the breast area, especially in thin women. This is due to the trauma to the tissue in using the scope for implant placement. The third... more
Julio Garcia, MD

Las Vegas Plastic Surgeon
+1

Transumbilical breast augmentation?

I do not think that this is a good operation for the reasons my colleagues have discussed below. I see, in my practice, more patients for revisionary surgery after the TUBA procedure (taking into account the relative numbers of procedures done through different approaches) then after breast augmentation procedures done through the other approaches available. Make sure you seek consultation with well experienced what certified plastic surgeons. Best wishes. more
Tom J. Pousti, MD

San Diego Plastic Surgeon

www.poustiplasticsurgery.com

+1

Trans Axillary is a better option

I prefer the trans-axillary (through the armpit) approach. This also avoids any scar on the chest, and allows a much more precise placement under the muscle. Also with the Keller Funnel I can place Gel Implants up to 600cc through the axilla. The scar is usually hard to find. see video
Rodney A. Green, MD

Cleveland Plastic Surgeon
+1

TUBA breast augmentation

TUBA or transumbilical breast augmentation is the least used method for breast augmentation. I cannot endorse it and have seen many complications from other surgeons. There is very little control of the pocket for the implant and as it is almost a blind procedure, there are more risks of bleeding, asymmetry, etc. It is nearly impossible to place a breast implant in the submuscular position by the TUBA method. Do not be fooled by slick advertising methods. Most surgeons who advertise this... more
Leo Lapuerta, MD

Houston Plastic Surgeon
+1

TUBA under the muscle

TUBA under the muscle is possible but I am not a big fan. I think you get a better result with precise definition of the infra-mammary fold ( fold under the breast) with a more traditional incision. Ultimately these incisions are typically quite imperceptible. All the best, Talmge J. Raine MD FACS
Talmage J. Raine, MD

Chicago Plastic Surgeon
+1

TUBA technique

The short answer to your question is yes, a sub-muscular placement is possible with a TUBA approach. But my concern at the moment with the TUBA technique is how one would control arterial bleeding if you do place the implant under the muscle. Invariably, you would want to release the pectoralis muscle at the inferior border and would most likely avulse some small arteries (perforators) that would be difficult to control. Hope that helps you
George Min, MD

Kirkland Plastic Surgeon
+1

TUBA Breast Augmentation

I personally think that a transumbilical breast augmentation is an operation that should not be done as it has significant inherent risks. There are much more risks than benefits and is something that has had significant morbidity. I do not recommend it as there are far more accessible routes to perform breast augmentation. These include transaxillary (armpit incision) as well as inframammary fold. These provide for more optimal results, as well as correction of asymmetries. In most cases,... more
Rod J. Rohrich, MD

Dallas Plastic Surgeon
+1

Breast Implants - TUBA and Submuscular Implants

Hi Meeko in san jose, Yes, you can. You should, as with any other procedure, be sure that you go to a board-certified plastic surgeon who's experienced in the technique(s) you're interested in. Implants can, in general, be placed in the submuscular position even via a TUBA technique. As you probably know, you'll need to opt for saline filled implants (rather than silicone gel) if you want TUBA. I hope that this helps, and good luck, Dr. E more
Alan Engler, MD

New York Plastic Surgeon
+1

TUBA

I also am not a large proponent of this procedure, while it leaves you with no scar on the breast it does have some concerns as far as revisions and placement. If you are set on having this procedure--I'd recommend you see Dr. Edwin Pound as he does more of these than anyone in the country to my knowledge.
Thomas B. Lintner, MD

Atlanta Plastic Surgeon
+1

The TUBA procedure is a good operation

I have been doing the Trans-Umbilical Breast Augmentation (TUBA) for almost twenty years now and approximately 4000 patients from all over the world. I have a LOT of experience with this approach. It can be done with the implants placed above or below the chest muscle. The benefits of the TUBA approach is that there is only a single small scar hidden within the belly button. Also, since there is less cutting of the tissue, the recovery seems to be faster and there is... more
Edwin C. Pound, III, MD

Atlanta Plastic Surgeon
+1

TUBA risks and benefits

I am not a proponent of tis procedure due to its limitations including difficult access to the sub muscular plane, higher incidence of improper placement and limitation to saline implants.  Be sure to weigh the benifits of perhaps a less noticeable scar with these issues.  Be sure that any surgeon who does a TUBA is familiar with the more traditional inframammary or areolar incisions so that in case an issue arises he or she is capable of fixing the problem, which may be... more
Terrence Murphy, MD

Englewood Plastic Surgeon
+1

TUBA - Can it be done under the muscle?

In a word - yes! In fact, I think the surgery is technically easier to perform under the muscle than trying to insert the implant on top of the muscle. Another point I would make is don't be discouraged and keep looking for someone who has experience with this approach. There are a lot of 'theoretical' objections to this procedure, but for the right patient it  is a great technique. There is only one small and inconspicuous incision and results should be comparable to... more
Jon F. Harrell, DO

Miami Plastic Surgeon
+1

TUBA Breast Augmentation - Breast Implants through the belly button

TUBA breast augmentation is performed by making an incision around the belly button and tunneling the implants up to the breasts. It is not approved to be performed with silicone implants and therefore, this technique is reserved for saline implants. In addition, the rate of complications and lower of level of patient satisfaction with this technique even in the most experience hands results in few qualified plastic surgeons offering this procedure. Although it may seem attractive, the... more
Ankit Desai, MD

Jacksonville Plastic Surgeon
+1

TUBA and unattended consequences

The problem with TUBA's that most surgeons don't mention is that even if you have no complications, someday your implants will have to be replaced and either a peri-areolar or inframammary incision will need to be used. The same can be said of the transaxillary (under arm) approach. I have seen this happen a number of times and I can tell you the women were unhappy about not being warned about it. TUBA's are not what they are cracked up to be.  The procedure is... more
Lori H. Saltz, MD

San Diego Plastic Surgeon
+1

Why you shouldn't do the TUBA

The answer to your question is, yes you can place implants under the muscle. The problem with the TUBA is that it is a blind operation. In order to get consistent results, the surgeon should be able to see the dissection of the muscle. This is impossible in the TUBA, the muscle is literally torn in a blind fashion. For a minimal scar operation I prefer the trans-axillary approach. Using an endoscope I can clearly visualize the muscle and be very precise with the dissection. Furthermore,... more
Jose M. Soler-Baillo, MD

Miami Plastic Surgeon
+1

TUBA Hip or Hype?

This method of augmentation  has been marketed as being nearly scar-free.  However, as you know, what is marketed and what is reality are two different things.  I don't perform this procedure due to the high rate of complications and long term poor outcomes.  In general, this technique places implants in the subglandular plane (just under the breast).  This increases the risk of capsular contracture and visible rippling.  I have performed revisions... more
Jason R. Hess, MD

San Diego Plastic Surgeon
+1

TUBA Breast Augmentation: Don't play pin the breast implant in the patient

The TUBA breast augmentation procedure is a blind and blunt procedure which likely places the implant under the breast glandular tissue though there is no way to confirm this. As a plastic surgeon doing the procedure once should tip you off that this is not a good procedure and likely leads to a high rate of breast implant malposition, scarring, and revisions. Breast augmentation should have a high degree of precision with a low complication and revision rate. Don't play games with your... more
Andrew P. Trussler, MD

Dallas Plastic Surgeon
+1

TUBA breast augmentation implant can be placed above or below the muscle.

In my opinion, the TUBA is much ado about nothing.  Therefore, a don't do it.  But the implants can be placed above or below the muscle.
Vincent N. Zubowicz, MD

Atlanta Plastic Surgeon
+1

You can use it to place the implants beneath the muscle, but why would you!

You can use it to place the implants beneath the muscle, but why would you!  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... more
Richard H. Fryer, MD

Salt Lake City Plastic Surgeon
+1

Breast Augmentation

TUBA is not a widely performed procedure. Most board certified plastic surgeons would choose other methods. The TUBA cannot be done with gel implants and the manufacturers do not like to have the implants placed this way do to the ruff handling of the implant during the procedure.
John C. Pedersen, MD

Akron Plastic Surgeon
+1

TUBA: Teaser fare.

Of all the remote access incisions for breast augmentation, I am most reluctant to endorse this one for the following reasons: 1. It doesn't allow refinements of the dual plane pocket dissection, so that the cleavage is a function of how much the pectoralis muscle can be avulsed (stripped) off the breast bone. Additionally, if the breasts are intially uneven, with regard to the distance from the nipple to the fold, very little adjustments can be made to correct these fold differences. 2. It... more
Lavinia Chong, MD

Orange County Plastic Surgeon
+1

Breast Augmentation through TUBA not recommended

TUBA is not recommended by breast implant manufacturers and by most plastic surgeons. It is truly a blind approach and can commonly lead to malpositioning. I give my patients this analogy whenever they ask about TUBA. Imagine putting lipstick on your lips, not with the normal short stick, but attached to the end of a broom handle! Why would you?? It's a lot easier and safer to do it with a periareolar (around the nipple) or infrmammary (under the breast) approach. There are very few people... more
Sirish Maddali, MD

Portland Plastic Surgeon
+1

TUBA not Encourage or Recommended

Most board certified plastic surgeons will NOT perform this operation as they genuinely know better. This is not a good procedure and is know to have issue with it. Most commonly since it is a blind procedure like the arm pit incision (which has shown to have a high rate of malposition) it too has the same issues. The periareolar incision heals exceptionally well, so why take the risk and chance with your breast surgery. Remember if it is not done right the first time, it will never... more
Farbod Esmailian, MD

Orange County Plastic Surgeon
+1

Yes if a well-trained plastic surgeon does it

Meeko, I do not perform this procedure but in courses I have attended the implant can be placed under the muscle if the surgeon has a lot of experience. The problem with this procedure is that it is novel and many non-plastic surgeons will offer it to try create a niche. I personally do not like the procedure because it is essentially performed in a blind fashion and I have seen patients with marked asymmetry and implant malposition after TUBA. You also must realize that if there were a need... more
Michael C. Edwards, MD

Las Vegas Plastic Surgeon

www.medwardsmd.com

+1

It may be difficult to place the implant under the muscle with TUBA approach

You have to understand that the TUBA submuscular approach, from what I understand, is essentially a blind procedure. That means that you have to guess that you are under the muscle when placing the conbduit from the umbilicus. This is not a precise operation and therefroe the vast majority of plastic surgeons are somewhat reluctant to perform it.
Otto Joseph Placik, MD

Chicago Plastic Surgeon
+1

Be cautious

I recently saw a patient who had the TUBA operation performed in California. She presented with quite a marked asymmetry. At surgery we discovered that they had placed one implant on top of the muscle and the other under the muscle. I have never seen or heard of this done by the more the standard procedures. It is very difficult to get good symmetry with this operation.
Robert M. Jensen, MD

Medford Plastic Surgeon
+1

I don't recommend TUBA.

Hi. I don't know any experienced board certified plastic surgeon in Manhattan who does the TUBA breast augmentation procedure.  If you have implants put in through the belly button, the warranty becomes void.  That tells you what the manufacturer thinks of this operation.
George J. Beraka, MD

Manhattan Plastic Surgeon
+1

TUBA may not be best for you

TUBA or TransUmbilical Breast Augmentation is probably the rarest method of breast augmentation. It sounds appealing since the incision is in the umbilicus or belly button. However, procedures through this incision for the breast are very difficult to obtain comparable results to the more common methods of breast augmentation. The implant can be placed under the muscle through this method, however, alignment and placement are more difficult to obtain through this method. Good luck. more
David Shafer, MD

New York Plastic Surgeon

www.ShaferPlasticSurgery.com

+1

Tuba is a tough instrument to play...

Meeko, There is a reason why TUBA has not gained wide acceptance in the plastic surgery community.  The concept is great.  The practice is limited by the technical difficulty of controlling the results from such a remote access and to the use of saline implants.
Kenneth R. Francis, MD

Manhattan Plastic Surgeon
+1

Because you can doesn't mean you should

Yes, you can use the TUBA approach for submuscular implants. But you should do more research on the pro's and con's of each approach before you make a final decision. Every technique has some advantages/ disadvantages. Only you can decide if having a scar around your umbilicus, instead of approximately a one inch scar under your breast, is worth the trade offs. If you do decide on the TUBA approach, I would see a surgeon very experienced with that technique.
Dean Fardo, MD

Atlanta Plastic Surgeon
+1

TUBA for implants

TUBA refers to transumbilical breast augmentation.  Yes, the implant can be placed under the muscle this way. But, it is very difficult to maintain control of the  pocket if there is bleeding.  You also can not place gel implants this way.
Steven Wallach, MD

Manhattan Plastic Surgeon
+1

Most people want gel and can't have a TUBA

 The gel implants provide a far superior "feel" to the salines.  Since gels can't be inserted via the TUBA, there is questionable benefit from a remote scar but still using an implant that can have wrinkles and ripples much more often than not. Alos, no revisions can be done through the TUBA scar so you would need a new scar in the event of a revision.  The TUBA isd going extinct!
Richard P. Rand, MD, FACS

Seattle Plastic Surgeon
+1

TUBA

The answer is yes.  The breast implants, and only saline breast implants in the case of TUBA, can be placed either above or below the muscle. 
Edmond A. Zingaro, MD

San Francisco Plastic Surgeon

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