Can MemoryGel Implants Be Inserted with T.U.B.A?

Is this possible? I am 20 years old, 5"2 and weigh about 105 lbs. I am currently a very small B cup and would like to be a C. I heard memory gel implants are safer (do not leak) so i am leaning towards this type of implant. If T.U.B.A is unable to be used with the memory gel, what is the likelyhood of me being unable to breast feed in a few years if going through the nipple? I hate/am terrified of pain, what is the most painless way?

Doctor Answers 7

TUBA insertion of Silicone Gel Breast Implants?

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Thank you for your question.  No, I do not recommend the TUBA method for any type of breast implant - especially silicone gel breast implants.

I would ask you to please be careful in your choice of surgeons for your breast augmentation surgery.   I personally like the infra-areolar incision.  I believe this incision heals nicely and allows for great access to the achieve the best possible symmetry.

Yes, there may be discomfort for a few days with breast augmentation surgery with the breast implants placed under the muscle but in general, this will give you the best, long term result.

Visit with well experienced, board certified plastic surgeon who can show you many examples of their work.

Memory gel implants cannot be inserted via umbilicus (TUBA). Avoid PS who "market" overnight recovery or "painless" BA.

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You admit to being terrified about pain, so you are susceptible to those plastic surgeons (or even non-ABPS-certified "cosmetic surgeons") who market so-called "painless" breast augmentation, or overnight recovery, 24-hour recovery, or "flash" recovery breast augmentation. Of course they want you to think they have some "special" or proprietary technique that ONLY THEY possess, in order to snake you in like some carnival barker!

Carefully-performed breast augmentation can indeed be nearly pain-free; many of my patients tell me (the day after surgery when I see all of my augmentation patients) they have 0 on a scale of 10 for pain. Of course, most patients actually say they have a 2,3, or 4 on a 10 scale, and yes, a few will say 6 or 7. But the vast majority are shocked that they have minimal swelling, virtually no bruising, and discomfort rather than PAIN! (And yes, I do nearly all submuscular dual-plane augmentations with memory gel implants.)

I believe that since TUBA is off the table (for reasons clearly discussed by many of my colleagues in their answers), your best results will be obtained with a inframammary crease incision. Axillary incisions may be concealed nicely in some patients, but there is a higher incidence of pocket malposition, and a slightly higher incidence of capsular contracture from armpit bacteria, and more chance of damaging sensation to the nipple since the dissection is right over the course of the (lateral 4th intercostal) nerve to the nipple.

Periareolar incisions divide some of the breast ducts needed for breast feeding, and can also divide some of the terminal branches of the nipple sensation nerve. Plus, there are the intraductal bacteria that the implant must pass through on its way to the pocket--more risk of biofilm-induced capsular contracture.

So, the inframammary crease incision (3.5-4.0cm, about 1 1/2 inch) avoids the armpit and ductal bacteria, minimizes trauma to the milk ducts, and avoids the nerve the best (though 5-10% of women may still experience nipple numbness regardless of incision choice).

The most painless way is with the most careful and precise surgeon who utilizes no-touch technique in implant handling (Keller Funnel), Betadine or Adams formula antibiotic irrigation, submuscular placement, long-acting local anesthetic in the breast pocket, IV steroid to reduce swelling and nausea, TIVA anesthesia for rapid wake-up with 2-3% nausea rate and no "hangover" or overnight stay, muscle relaxants, anti-inflammatory medications that do not increase the risk of bleeding, and caution about excessive activity post-op. (All of which I do for well over 100 breast augmentation patients per year).

It is absolutely critical that you choose the best surgeon, NOT a technique, brand of implant (or "named" trademarked procedure), or incision.

Choose an experienced ABPS-certified plastic surgeon who does lots of this surgery and follow his or her recommendations. For more information on all of your questions, read my article by clicking on the web reference link below. Best wishes! Dr. Tholen 

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 263 reviews

T.U.B.A. and Memory Gel Implants

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Dear Mk1992,

Lots of questions so let's take them in order.

No, you should not insert a silicone gel implant in through the navel.  This would difficult if not impossible and the damage to the implant would be significant.  Lastly, there is a reason why this technique has never "caught on" with most plastic surgeons; of all the incision choices, it offers the least amount of precision and control.

Are memory gel implants safer and do not leak?  While the implant company will be glad to tell you this, there is very little evidence outside of the company marketing data to prove this point.  All implants that are approved by the FDA are safe.

If breast feeding is very important to you, then the under the breast incision would be an good choice for placing your implant.  The periareolar incision can interfere with the future ability to nurse.  Both techniques can be performed using a minimally traumatic technique which should limit your post op pain.

Herluf G. Lund, Jr, MD
Saint Louis Plastic Surgeon
4.7 out of 5 stars 88 reviews

Very few plastic surgeons recommend T.U.B.A.

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Hi.  Here are some thoughts that may be helpful to you:

1)  Of course you cannot push a silicone implant in through the belly button, but I think this is not a good idea even with saline implants.  It is so traumatic to the implants that it voids the manufacturer's warranty!.

2)  Breast implants cause only moderate discomfort with quick recovery.

3)  Breast implants do not interfere with breast feeding.

4)  For most women, a short incision in the fold under the breast is best. MemoryGel implants are a good choice.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

Can MemoryGel Implants Be Inserted with T.U.B.A?

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NO - cannont do TUBA.

The incision you chose will not affect sensation or the ability to nurse in the futrue.  Pain with a breast aug is related more to the placement of the implant.  Implants above the muscle will cause less pain and quicker recovery.  My patients are back to work in a day or two usually.  Most of my breast augs are done withthe incision in the fold.

Rigo Mendoza, MD
Tampa Plastic Surgeon
4.4 out of 5 stars 40 reviews


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The circumareolar incision would probably be the best one for you. I also use a local anesthesia that lasts for 3 days, so you have minimal pain. Implants don't stop you from nursing.

William B. Rosenblatt, MD
New York Plastic Surgeon
4.2 out of 5 stars 12 reviews

Gel implants through the navel??

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Cannot be done


The incision in the navel, and the tunnel in the abdominal fat works with saline because the implants go in empty and can be rolled into a small volume, and then filled when it is in the pocket. Gel implants need an incision about two inches long, give or take a bit.


Furthermore, unless your areolae are rather large and the implant you choose not too large, it may not be a good choice to use the areolae for insertion leaving the breast fold or the axilla as choices. Most surgeons would favor the fold.

Because there are options, the choice of incision gets more attention than other more important choices which really do affect the outcome--type and size of implant, position above or below the muscle, need for nipple re-positioning.

There is no evidence that any of the incisions is safer in terms of not interfering with the possibility of nursing, though that is an unlikely consequence in any event. There is no evidence that any incision is less painful than the others. Basically, the same operation is done regardless of the incision used. 

Best wishes.

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

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.