Does a trans abdominal breast augmentation have just as good results? (photo)

Question

I have asked this question, but didn’t post pics. I couldn’t edit the question so I’m asking again. At my consultation, a TABA was recommended. I am wanting a tummy tuck and augmentation. After looking at me, the doctor recommended doing my augmentation using my tummy tuck incision. Which sounds great. Only one scar to worry about. I’m not finding much information about it when I started researching it. I’m just wondering if the procedure is just as successful as others.

John LoMonaco, MD, FACS · Answer

I was taught that the breast fold is a "no-fly zone" and that surgery which affects the area too much can lead to unexpected or unwanted results.  After trying a few implant placements through the tummy tuck approach, I learned it the hard way.Nothing compares to the accuracy, precision and safety of using a small incision at the bottom of the breast to insert the implants. BTW, if you ever have breast surgery again to replace the implants, upsize, downsize, or remove, etc. you will end up with that incision anyway !

Stephen T. Greenberg, MD, FACS · Answer

Thank you for your question.  Typically I do not recommend this incision.  I personally feel this type of incision increases risks during a breast augmentation and post operative.  I would recommend a crease incision underneath the breast and have the implant placed under the muscle.  The incision heals better and the long term results are a lot better.  Best of luck to you.

Edwin C. Pound, III, MD · Answer

The technique that you describe, placing breast implants via a tummy tuck, has been around for a long time.  The Trans-Umbilical Breast Augmentation (TUBA) procedure arose from this idea as well.  This is a technique where saline-filled implants are inserted through a small incision in the belly button.  I have done many TUBA's and TABA's in my career.  It is a nice combination with the tummy tuck and implants and, as you mentioned, does not leave scars on the breast.  As long as your doctor is experienced, certified, and comfortable with this approach, you should do well.

Matthew J. Nykiel, MD · Answer

Hello and Great Question.  I appreciate the time you are spending researching this procedure.  My name is Dr. Matthew J. Nykiel.  I am a Board Certified Plastic Surgeon, a Fellowship Trained Cosmetic Surgeon, and a Breast Augmentation Specialist.
A TUBA breast augmentation is totally blind.  Meaning the surgeon cannot see what he/she is doing when making the breast pocket.  Typically, it gives inferior results. I hope that helps!  Best of Luck!
Matthew J. Nykiel, MD#CoreAesthetic#RealSelfTop100Breast Augmentation SpecialistBoard Certified Plastic Surgeon

Daniel Barrett, MD · Answer

Dear momof4est2008,I tend to prefer the periareolar incision because its the most well hidden. There is a natural border between the areola and the rest of the breast skin the hides the incision extremely well. You have to be completely naked to see it vs other incisions like transaxillary and inframammary are visible in clothing such as sleeveless shirts and bikini tops when extending your arms up. I've also noticed increased rates of bottoming out with inframmary incisions that is not reported. Transaxillary implants are always wide in appearance because the surgeon is not able to dissect medially enough to provide better cleavage. Ultimately, I can perform any of the incisions but I recommend the periareolar. There is no difference in sensation because the nerves that control nipple sensation come in laterally from the back and injury to them occurs when surgeons dissect to far laterally which is why transaxillary incisions have the highest nipple sensation disruption. There is no difference in breast feeding ability. One study did show a slight increase in capsular contracture with use of periareolar but that study was small and did not incorporate modern techniques such as below muscle placement, keller funnel usage and triple antibiotic irrigation.Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Miguel Delgado, MD · Answer

The reason you don't find much information is because it is an uncommon approach. There are higher incidences of complications, it is difficult to get the pockets placed correctly, among other issues. The most common incision today is the inframmary incision which has less incidence of capsular contracture and easiest access for placement of breast implants. Be sure to consult with a board certified plastic surgeon, see 2 or 3 in consultation an view many before and after pictures. Good luck.

Nelson Castillo, MD · Answer

Thank you for sharing your question and photographs.  Placement of breast implants through the incision and dissection performed during a tummy tuck is rare and increases the risk of implant complications such as bottoming out and other malposition issues.  It will also compromise some of the blood supply to the tummy tuck flap which can result in wound-healing issues.  In a word, I would avoid this approach to your mommy makeover. Hope this helps.

Pejman Aflaki, MD · Answer

Hello and thank you for your question and sharing your photos. The reason you are not finding much information about trans-abdominal approach is that it's not a common procedure. It is an unconventional approach to breast augmentation and most plastic surgeons don't do it. While the idea of avoiding extra incisions in the folds sounds good, creating the pockets for implants through the abdomen can be very challenging and potentially increase the risk. IMF incisions heal very nicely and are barely visible.  Patient attached in this video has had a tummy tuck and breast augmentation using infra-mammary incision. Best,

Robert M. Tornambe, MD · Answer

momof4 While avoiding additional scars in the folds of your breasts is enticing, the additional dissection required within your Tummytuck skin flap is fairly extensive and can affect wound healing. Also they section of the breast pockets arm much more difficult from this approach and implant asymmetry after this surgery more common.  Also dissection of the breast pockets is much more difficult from this approach and implant asymmetry after this surgery more common. Inframammary scars heal very well and fall into the folds nicely and rarely present a problem. Discuss your concerns with your plastic surgeon and request further description of exactly what he or she plans to do. Good luck.

Ari Hoschander, MD · Answer

The single most used incision for breast augmentation currently is the inframammary fold incision. It dwarfs the other incisions combined. The reason for this is that there appears to be the lowest risk of capsular contracture and the best potential for excellent implant placement.

Does a trans abdominal breast augmentation have just as good results? (photo)

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