Can you use the TUBA technique for under muscle?

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 areola is better or the crease that probably means he/ she prefers to do it that way. So if you go to that doctor that is the way you should do it. Going with the umbilcal technique does not void the warranty.

Yes! You can definitely go under the muscle with TUBA. But only if you don't need a lift with your implants. And only if you want saline rather then silicone. I suggest you first ask your surgeon the following question. Do I need a breast lift with implants or will a breast augmentation alone be enough?  If you need a lift, there is no point in avoiding a breast scar... we cannot lift the breasts without additional scars. 
Silicone Vs saline, is another conversation worth going into with your surgeon. In the TUBA technique, saline implants are placed via an umbilical incision, and then filled with saline once the breast pocket is ready and the implants are in place. For obvious reasons, we cannot do this with silicone implants. As long as the patient is a good candidate, good results can be obtained with any incision. That said, I think surgeons do their best work when their hands are not tied up because of a patient's preference for one scar or the other. This way, surgeons can chose the technique they feel is best for each particular case. Best of luck,Dr. Miguel Mota

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 advantages 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 incision 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.

Yes, you can have the implants placed over or under the muscle as long as the surgeon who is performing your surgery is experienced in the technique.

It is possible to put the implants below the muscle with TUBA approach, however it is important you find an experienced board certified plastic surgeon who specializes in this technique. It is very difficult to position the implants via TUBA, and even more difficult when placed sub muscularly.

TUBA, or Trans-Umbilical Breast Augmentation, involves implanting the
breasts from the belly button. It uses the abdominal area to get the
tuba implants up to the breast area. When it gets to the breast area, it
pours a Tuba breast implant gel. This procedure must not be used on
someone who already had a breast implant. Doctors recommend operating on
“virgin” skin. Via the navel area, the doctors can avoid scarring the
tissue. In the end, the procedure does not produce any new scars.

I think that there is evidence in the literature to suggest that saline implants can be placed under the muscle using the TUBA technique with good results. I personally do not use the technique because I have not had a reason to do so. The most obvious reason to consider the TUBA technique is to avoid a visible scar. The fact is that breast augmentation using more traditonal techniques, if done thoughtfully and carefully, results in a very well disguised scar. I know that in my hands, the best result is going to be using an IMF crease incision. If you wish to use the TUBA approach, find a board certified plastic surgeon that is open and honest about his results and complications. Best of luck.

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 excellent results without a visible scar.  I have even performed reoperations through the navel to exchange a deflated implant with this approach.  If you are a saline candidate (in my practice thats someone who wants a moderate (less than 2cup) size increase and may have some size assymetry), find the best board certified TUBA surgeon near you, ask them how many they have done, if the answer is more than 100, do it with them.   

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 recommend a transaxillary approach.  the scar is well hidden, and again, off of the breast.

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 nice breast augmentation result, customization of the procedure to the patient is necessary and is nearly immpossible with TUBA.  I dont like scars on the breast either which is why I routinely use atransaxillary (under armpit) subfascial approach to give my patients natural appearing results.  I strongly suggest that you look into transaxillary subfascial placement.

 

All the best,

 

Rian A. Maercks M.D.