It sounds like it could be a good idea—transumbilical breast augmentation, or TUBA. Yes, the incision is made in the navel, and yes, the obvious advantage of the procedure is that scars are nearly nonexistent.
But how do implants get to the right place, you ask? Well, there’s the rub, or at least the possible rub. Many plastic surgeons do not perform TUBA precisely because they feel it’s more difficult to position breast implants properly.
During the procedure, a small device called an endoscope with a camera is inserted into an incision in the umbilicus, or navel. A tunnel threading under the abdominal skin to the breast forms the pathway for the rolled up, deflated implant to travel. After inserting the implant, the surgeon fills it with sterile saline solution and removes the fill tube. When both breast implants are in place, the small incision can be closed.
Plastic surgeons who are proponents of TUBA generally feel the procedure has many advantages. Along with the small incision required, TUBA causes less bleeding, fewer complications and less pain than other methods, therefore allowing patients to recover more quickly from surgery, these plastic surgeons say.
If these assertions are true, then why don’t more plastic surgeons offer this approach? And is TUBA an option for you if you’re considering breast augmentation? Here are some things to think about.
First, due to the fact that silicone gel breast implants come pre-filled by the manufacturer, saline implants are the only type that can be used for TUBA. Many plastic surgeons prefer silicone gel implants for their natural look and feel after surgery; this may figure into why more don’t offer TUBA. Whether it does or not, you should probably evaluate both types of implants.
Second, there’s quite a bit of disagreement among plastic surgeons about whether endoscopy is an appropriate technique for breast augmentation. It’s true that many successful surgeries are performed endoscopically these days—the cameras contained in the devices allow surgeons good visibility. Indeed, one plastic surgeon maintains that those who do not offer the TUBA procedure are not experienced or skilled with an endoscope.
But another plastic surgeon who sees two or three unhappy TUBA patients each month says that while visibility is important (referring to the endoscope), equally important to the surgeon is the sense of touch. This particular surgeon says the women he sees who are dissatisfied with their TUBA results most often have implants that are too high or too widely spaced apart—implant positioning problems. This professional believes that surgeons who perform TUBA are less apt to achieve the beautiful, symmetrical results their patients want without using both eyes and hands.
As with all judgment calls, there’s really no clear right and wrong answer about TUBA. If you’re considering breast enlargement, I urge you to keep the whole picture in mind, to take a broad view of your ultimate goal. You’re thinking about surgery because you want full, natural looking breasts. There are many factors to evaluate and choices to make to get there—the scar is just one of them.