Transumbilical breast augmentation (TUBA) is a surgical technique that involves inserting a breast implant through an incision in the belly button, also called the umbilicus. Although the technique has been practiced since 1993, it is somewhat controversial, and few plastic surgeons use it. However, the safety and efficacy of TUBA has been well demonstrated in the scientific literature.  Because of its advantages for certain groups of patients, this unique surgical approach may be appropriate for you.

How TUBA Surgery Works: Step By Step

Here is how Dr. Neal Handel, a plastic surgeon at UCLA, describes his technique in the journal Clinics in Plastic Surgery.

  • The patient receives general anesthesia so that she will be asleep during the entire operation. The surgeon also administers a local anesthetic into the navel and the breasts.
  • The surgeon makes a tiny, curved incision in the top fold of the belly button and uses a thin metal rod to carefully form two delicate tunnels below the skin, starting at the belly button and moving up the abdomen to each breast. 
  • Once the surgeon creates a pocket for each implant, he or she inserts tightly rolled inflatable expanders through the tunnels and into each breast to prepare the pockets for the implants.
  • Finally, the saline implants are threaded through the tunnels and inflated. In most cases, round, smooth implants are used.

Some surgeons prefer to use an endoscope, a device with a tiny light attached, to guide the procedure.

Benefits of TUBA

This unique procedure has been shown to have a number of advantages, including the following:

  • Because the incision is made in the belly button, TUBA results in a scar that is difficult to see and located far from the breasts.
  • It is well-suited for large implant sizes.
  • The surgeon has a great degree of control over the shape of the pocket and location of the implant.
  • It is less painful than other breast implant surgeries and has a short recovery period.
  • It is especially appropriate for patients who have small areolae (the darker circle of skin around the nipple) or smaller inframammary folds (the fold at the base of the breast).

Drawbacks of TUBA

  • If revision surgery is necessary, it will typically require an incision in another location.
  • Patients should know that placing saline implants through an incision in the navel is technically “off label,” meaning that implant manufacturers did not study this method of insertion when they applied for FDA approval.  However, surgeons are free to use this approach, and certain manufacturers still guarantee their products when the TUBA technique is used.
  • You may need to search for a surgeon who is qualified to perform this rare operation. Your surgeon should have received specialized training in this method. Typically, the completion of a focused, four to five day training course is recommended.

Although inserting a breast implant through the belly button may sound like science fiction, it is a safe and feasible option that may be right for you. Talk to your surgeon for more information.

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