Doctor Recommendation for Trans-Umbilical Breast Augmentation in New York

I just saw a video online of Trans-Umbilical Breast Augmentation.I thought to myself amazing.I really dont want any visiable scars and this would be perfect.But after reviewing this procedure it seems like a risk.I want a natual appearance and feel.I'm currently a size 36B and just want to gain one cup size.Has anyone had this procedure and can the implant be placed under the chest muscle ?

Doctor Answers 11

Trans-umbilical breast augmentation.

Breast augmentation performed through the belly button is called trans-umbilical breast augmentation or TUBA. In this procedure an incision is made at the top border of the belly button. A hollow tube is then pushed through the fat layer under the skin from the belly button up to the bottom of the breast. Through this tube a space is created either under the breast tissue itself or under the muscle layer. An inflatable temporary device attached to a long filling tube is then pushed through the hollow tube into the breast pocket. This device then expanded to help create the pocket. After the pocket is created an empty saline implant attached to a long fill tube is pushed through the hollow tube and placed in the pocket. The saline implant is then filled and the attached fill tube is then removed. The implant is designed so that it seals itself after the fill tube is removed from the valve in the implant. The TUBA procedure remains controversial and is not widely recommended. Although seems ideal to minimize the visible scarring associated with breast enhancement the trade-offs are significant. With this procedure only saline implants can be utilized. The pocket is created bluntly from a remote location limiting the precision of pocket dissection. The precise creation of the ideal pocket for each patient is the key to the creation of an ideal breast shape. Because of the limited precision in creation of the pocket the revision rate of this procedure is significantly higher than other procedures done under direct vision. When the pocket is created bluntly there is more chance for postoperative bleeding. Even a small amount of blood remaining in the pocket can cause future capsular contracture. Another potential problem with this procedure is scarring in the fat tissue through which the dissection tube is placed. This can leave a permanent mark extending from the belly button up to the breast. Most patients are selecting silicone implants and would prefer a technique which results in a more predictable outcome and less chance for need for future revisional surgery.

Omaha Plastic Surgeon
5.0 out of 5 stars 90 reviews


TUBA is not a technique that most surgeons perform because it requires special training and higher skill. However, I have performed TUBA for years. It is safe and actually involves a shorter recovery period than other breast augmentation techniques.

The implant is placed via an incision hidden in the belly button. This leaves no visible scar anywhere near the breast. (Even the armpit incision can sometimes be very visible in a bathing suit or strapless top or dress.)

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.

TUBA approach

Transumbilical breast augmentation is not popular because it makes placement of the implants more difficult. Only saline implants may be used as well since the path to the breasts has to be small, allowing only for an implant shell.

Trans-umbilical breast augmentation (TUBA)

I have done over 5000 TUBA procedures over the past 23 years with excellent results.  Implants can be placed above or below the chest muscle using this approach.  The big advantage to the TUBA approach is that there is only a single scar hidden within the belly button.  The disadvantages include the fact that only saline-filled implants can be used with the TUBA approach.  Also, if any future surgeries are required or if there are any problems that occur during the initial surgery, a different incision site may become necessary.  I would suggest finding an American Board of Plastic Surgery-certified doctor to do your surgery as there are a LOT of non-ABPS-certified doctors out there offering this procedure. 

Edwin C. Pound, III, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 18 reviews

Transumbilical breast augmentation

There is a lot of misinformation about trans-umblical breast augmentation surgery or TUBA.  This is due to the fact that there are few plastic surgeons who have been exposed to or trained in this procedure.  This leads to many thoughts and opinions on the procedure that have been perpetuated without basis in experience or scientific evidence.

To answer your questions:

Can a natural look and appearance be achieved with a TUBA?

Yes.  Although no size can be guaranteed with any breast implant technique, it is possible to have a modest increase in size without having a "fake" look.  Your goals and preference should be clearly discussed with your surgeon before having any breast augmentation.

Can the implant be placed under the chest muscle with the trans-umbliical technique?

Again, yes.  In fact, with the TUBA, it is easier and more commonly place under chest muscle than above.

The TUBA procedure has been performed safely in thousands of women however, like every other technique there are benefits and risks that should be discussed with your plastic surgeon.  When asking about transumbilical breast augmentations make sure you discuss it with a plastic surgeon who is comfortable performing this procedure and that he or she is certified by the American Board of Plastic Surgery.

Adam Hamawy, MD
Princeton Plastic Surgeon
5.0 out of 5 stars 24 reviews

Transumbilical breast augmentation

TUBAis a procedure to plae SALINE implants through the umbilicus through a narrow tube up into the chest.  I have used TABA transabdominal breat augmentation for patients undergoin abdominplasty surgery. But this is done under direct vision.  I can use saline or silcone implants this way. In fact, I used to give a course on this at our national meeting.  I do not think using  TUBA is the best way for a primary procedure, because of the limited visibility.

Steven Wallach, MD
New York Plastic Surgeon
4.0 out of 5 stars 22 reviews

Doctor Recommendation for Trans-Umbilical Breast Augmentation in New York

There are many pros and cons to the Transumbilical Breast Augmentation (TUBA) procedure. You should educate yourself on them. Dr. Leonard Grossman has probably the largest experience in the New York area with this operation. Look his website up and educate yourself.

Dr. Peter A Aldea

Peter A. Aldea, MD
Memphis Plastic Surgeon
5.0 out of 5 stars 83 reviews

Not a good ideal

The most important thing concerning breast augmentation is that it is NOT a one time operation-period!!


You will require revisions within your life time.  When you do you will not be able to use the belly button incision and most likely not the armpit  especially if revision is due to capsular contraction.  Mal position is more common with the belly button and  armpit incision as well.  also with the belly button you can only use saline implants.

Any problem with a breast implant is a serious issue.  Do your self a favor a consult a few more board certified plastic surgeons, like the one above in new york.

Miguel Delgado, MD
San Francisco Plastic Surgeon
5.0 out of 5 stars 54 reviews

It's not ideal. Getting the implants in the right position is more important

It's not so amazing.  You cannot place the implant under the muscle if you introduce it through the belly button.  The dissection is more difficult too.  Plus you are almost certainly going to have another implant operation in the future and redos are not usually possible through the belly button.  The scar can be very favorably on the breast.  You might want to consider having the periareolar approach.  Keep in mind, the belly button scar does not always heal so well and might well be more conspicuous than a periareolar incision or even an inframammary one.  The size of the implant does not matter too much either way. 

There is a reason that trans-umbilical breast augmentation never really caught on.  Much more important than the incision is proper dissection of the pocket, which is more difficult with a distant approach.  The incision is likely going to be quite acceptable either way.  But you need to have proper dissection of the pocket to provide a natural look, cleavage, as much symmetry as possible, and also avoid the U-shaped bookend look.  So think more about the appearance and shape of your breasts and not so much on the incision.

Eric Swanson, MD
Kansas City Plastic Surgeon
4.5 out of 5 stars 43 reviews

See a board certified plastic surgeon

Cassie, I see you are asking 2 sets of questions re breast augmentation. I have been doing this surgery and teaching residents for over 30 years. From my personal point of view there are two fads to be avoided. One is trans umbilical augmentation and the other is trans axillary. Both of these have a higher incidence of problems, such as malposition - then if you need it re done, there is a scar on the breast. So why not have a tiny scar part way around your areola which is quite inconspicuous and have the surgery done correctly the first time.

If there are only one or two surgeons doing a procedure you need to ask why --- the answer is that it is not a great procedure.

William B. Rosenblatt, MD
New York Plastic Surgeon
4.0 out of 5 stars 10 reviews

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.