For many women, breast size and shape is an important part of feeling desirable and sexy. Breast augmentation procedure can improve self-esteem and confidence. Today, breast enhancement or augmentation is one of the most frequently performed aesthetic procedures in the USA. It is performed on an outpatient basis using general anesthesia.
Traditionally, breast implants have been inserted through incisions on the breasts or close by - either around the nipple-areola complex, in the fold underneath the breast, or the armpit. Now, with the use of endoscopic technology, breast implants can be inserted through the belly button, leaving no scars on the breast or the body. No one has to know that you have had augmentation but you. Transumbilical Breast Augmentation (TUBA) or Endoscopic Breast Augmentation (EBAM) is a scarless breast augmentation procedure that was pioneered by Dr Gerald Johnson, in October, 1991. The procedure was first developed by placing the breast implants through an abdominoplasty (tummy tuck) incision. Dr Johnson realized that he could use an endoscope, or the lighted camera, to tunnel through the fat and up to the breast area from a small incision made in the navel. In addition to eliminating scars on or near the breasts, this method allowed both breast implants to be placed through a single incision.
The Hurwitz Center for Plastic Surgery is now the only Plastic Surgery Practice in Pittsburgh that offers the TUBA procedure.
Advantages of TUBA Procedure
Misconceptions about TUBA
- A single inconspicuous scar deep within the navel
- Less invasive and thus less breast trauma
- Minimal bleeding
- Faster recovery
- Less risk of injury to the sensory nerves of the nipple and breast
- Shorter operative time
- Less anesthesia
Common misconceptions about the Transumbilical Breast Augmentation may exist, and incorrect information may be given to patients seeking advice. These myths were clarified in the American Society of Plastic Surgeons' Journal publication Volume 106, Number 1, July 2000.
1. Dissection of the breast implant pocket is too difficult from a remote location
- The pocket is created by expansion, not actual sharp dissection.
2. The rate of TUBA complications is higher than other traditional approaches.
- In fact, in trained hands the complication rate is 1/8 that of regular breast augmentation.
3. Bleeding cannot be controlled from a remote position.
- Remarkably, bleeding is sparse with the TUBA procedure. The rate is less than 0.5 % in published articles.
4. Implants positioning cannot be properly controlled
- In fact, during the expansion phase, the surgeon can modify and manipulate the final shape of the breasts and position of the implant.
5. Navel rings preclude TUBA procedure.
- This is untrue. The ring is removed prior to surgery and re-inserted after the procedure.
6. Since the implants are pushed through an endotube, they can be easily damaged
- The implants are not pushed through the endotube or via the tube. In fact, the implants will not make any contact with any instruments and are gently guided along the created tunnel by external pressure.
7. Visible abdominal track deformities
- No instances of visible track deformity on the abdomen were noted in the American Society of Plastic Surgeons' Journal publication Volume 106, Number 1, July 2000.
8. Since the implant is used as an expander, it becomes damaged
- A separate expander is used to perform the tissue dissection.
9. Implants warranty is voided because of the TUBA procedure
- This is untrue.
10. The TUBA procedure is a blind technique- This is untrue. An endoscope is used to confirm tunnel and breast pocket dissection and implant placement.
11. Prepectoral (subglandular) placement is the only option using the TUBA procedure
- This is untrue. Both subglandular as well as subpectoral TUBA procedures can now be performed.
12. Implants cannot be removed through a TUBA (umbilical) incision
- This is untrue. Implants can be removed through the umbilical incision to change size; with no secondary incision being needed.
13. Pain occurs in the abdominal muscles as a result of trauma and disruption
- The abdominal muscles are not disrupted. The procedure is performed over the abdominal muscles in the subcutaneous plane. Overall, the TUBA procedure is less painful than other procedures for breast augmentation, and results in a more rapid recovery for the patient.
14. If the patient has an umbilical hernia, the TUBA procedure cannot be performed
- The TUBA procedure offers an excellent opportunity to repair an umbilical hernia in appropriate patients.
15. The plane of the implant placement cannot be controlled by the surgeon
- The reason an endoscope is used is to verify where the implant pocket is positioned, relative to the pectoralis muscle.
16. An incision on the breast would be required to insert a drain
- Surgeons performing TUBA typically do not use drains, however if on the side of caution a surgeon chooses to insert a drain(s), the small tubes can be lead out via the navel.
17. Your surgeon can perforate your organs or lungs when doing the procedure.- This is untrue. The instruments are not sharp enough. The tunnels are created through
the fat beneath the skin, not where the organs are.
18. It is not possible to perform if you have had other abdominal operations.
- This is untrue. In fact, old abdominal scars can be used as an alternative site of entry.