Post-TUBA correction - can the same umbilical approach be used to correct asymmetry and double bubble effect? (Photo)

I am 30 year-old, asian, 5ft tall and weighs 92 pounds. 3 years ago I had 425cc saline implants placed under muscle through the umbilical approach ie. TUBA. About 3 months post-op I noticed slight assymetry where the lower pole is fuller and the inframmary fold is lower on my right breast. Subsequently, about 6 months post-op I started to work out (yoga and pilates) and I found out my right breast looked deformed when chest muscle is flexed. What can be done to resolve these issues?

Doctor Answers 6

Revision surgery

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Based on your photos, it looks as if you will need revision surgery. Which will not be able to be done through the same incisions. Speak with your surgeon as to your options. Best, Dr. Nazarian

Beverly Hills Plastic Surgeon
4.8 out of 5 stars 56 reviews

Tuba Revision

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One of the downsides of the trans umbilical approach is that revisions are not possible when anything other than more cutting is necessitated. In your situation, you will probably need some type of suture fixation and maybe a piece of Strattice to hold that left implant up. Most likely an inframammary crease incision will be necessitated. Good luck.

Marc J. Salzman, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 58 reviews

Post-TUBA deformity

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Thank you for your question and your pictures.  It appears that your implant is sitting too low (i.e.: below your infra-mammary fold) and will require surgical correction.  Unfortunately this cannot be done through the same incision and will require a different approach.  Most likely the best approach is an infra-mammary incision.  Best of luck in your process.  

Claire Duggal, MD
Annapolis Plastic Surgeon
5.0 out of 5 stars 8 reviews


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This is one of the limitations of TUBA, it is a blind procedure so it can be difficult to control all aspects of the augmentation, and revision surgery must be carried out through a different approach. An incision in the fold underneath the breast is the best option. At least with the approach through the axillae the surgeon can use a camera to ensure a precise pocket for the implant, but even in that approach any revision surgery must be carried out through a different approach.

Wendell G. Miles, MD
Chevy Chase Plastic Surgeon


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No. One of the drawbacks of TUBA is the inability to correct issues through the same incision. You will require a different approach this time.                                                                                                                

TUBA breast augmentation revision

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It looks like your left implants is sitting too low, and you have a problem with the submammary crease that needs to be fixed. This is practically impossible to do through a TUBA approach. You would need a different skin incision, most likely submammary (axillary wouldn't work either).

Ciro Adamo, PhD, MD
Italy Plastic Surgeon
5.0 out of 5 stars 18 reviews

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