I am in agreement with the other plastic surgeons who do not perform the TUBA. I will not do it because of increased risk of uncontrolled bleeding, inability to revise the result via the same incision, risk of umbilical (rather than breast) scarring which the patient may find objectionable, and also scarring in the "virgin" abdomen, which has not undergone prior surgery. I see absolutely no reason to use this method. No surgery is scarless. If a patient is that obsessed with scarring that she cannot accept a small scar which is hidden in the breast crease, then I would not want to operate on her This is a gimmick through and through and one which can have regrettable consequences.