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 37
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 popular for good reasons
It provides the surgeon with a very limited option of saline only implants, minimal to no control over the pocket creation for the implants (the pockets are created "blind'), high complication rates, and serious lack of consistency in results achieved. The only "benefit" of this procedure is a scar in the belly button. However, if the results are poor and largely unpredictable, then the scar is irrelevant.
One of the basic variables in augmentation surgery is where the scar is going to be. The important thing to understand is that their will always be a scar. The surgeons job is to ensure you achieve the best quality scar in the least visible location. Also, the surgeon should not compromise technical "perfection" by choosing a scar location that provides less control over what is being done internally to create the implant pocket and insert the implant. This is the problem with the belly button approach - the surgeon is compromising the quality of the surgery and results for the sake of a "trendy" scar.
Of course, like most things in surgery you will find differing opinions over what is the "best" approach.
With implant placement, only 3 incisions/scars are "commonly" used: armpit; lower areolar border; lower breast fold.
Each approach has advantages and disadvantages.
- Via the areolar is simply not possible when the areolar diameter is too small and therefore you are unable to pass an implant through a small access hole. Also, should the person scar badly it's not a great spot to have a bad scar - although this could be argued for all techniques.
- Via the armpit approach can scar nicely, with no scar associated with the entire breast mound. However, these can scar badly and therefore can never be hidden! A bikini/bra will cover any scar on the breast mound (areolar or lower breast fold). Also, the armpit approach means that the surgeon has the least control and is furthest removed from the areas that he/she needs most control in creating the pocket - the cleavage region. In addition to this, should the patient require any further surgery then it is general not possible to re-use these scars, so the surgeon needs to create another scar (such as in the lower breast fold).
- The lower breast fold incision is by far the most popular approach employed by plastic surgeons, and it is how I do the vast majority of my cases. The scar sits neatly within the lower breast fold crease. This approach provides the surgeon with the best control and management of the entire implant pocket and insertion/positioning of the implant. This scar can also be easily re-used should further surgery be required for whatever reason.
Furthermore, many would consider that the areolar and armpit approach can result in potential "contamination" of the implant as these areas have a higher bacterial load than the lower breast fold region. Whilst this would logically be correct I'm not entirely convinced it is clinically true and/or relevant. However, its another acceptable argument for not routinely using these approaches.
Breast Augmentation through the belly button
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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.