Breast implant surgery through the belly button is one of the most exciting developments since the original breast augmentation procedure. This surgical technique allows patients to circumvent the most common patient complaint, which is surely the possibility of postoperative scarring common to every other kind of implant placement surgery. Undergoing breast enlargement using a naval incision does have its drawbacks and limitations, but offers patients an alternative approach which is sure to satisfy many of their concerns about the augmentation process.
The technical medical name for this operation is transumbilical breast augmentation, often abbreviated TUBA. The procedure utilizes a small, completely hidden incision inside the natural folds of the belly button to gain entry to the breast tissue for implant placement. There are no visible incisions made anywhere in the anatomy and there will be no definitive evidence that augmentation has ever occurred. This procedure is unique in these aspects, as all other types of breast implant placement do use external and often noticeable incisions in one of 3 common locations. Before detailing the TUBA approach, let's look at the more common alternatives...
Periareolar breast augmentation is the most common in the USA and in many other areas of the world. This approach uses small semi-circular incisions in the bottom of the areola to place the implant directly into the breast. This technique can be used with saline or silicone implants, although silicone will require a much longer incision and will not work well for every patient, especially those with diminutive or light colored areolae. Scarring is often visible on the lower portion of the areola and can be extremely disconcerting if the scars are prominent. Additionally, being that this technique cuts into the actual breast mound, there is increased risk for complications including nipple sensitivity issues, breastfeeding issues and infection.
Inframammary breast augmentation is very common and is performed using a crescent shaped incision placed in the breast fold, under the breast mound. This inframammary crease is located exactly where the mammary attaches to the body, under the bulk of the breast. This is the original approach to augmentation and can be used with any type of implant prosthetic. Risk of infection and breastfeeding difficulties are decreased using this approach, as is the chance for diminished nipple sensation. However, this technique also has a serious downside. First, the scars are usually the worst with this method of placing implants and will be easily noticed when looking at the underside of the breast. Worse still is the fact that cutting into the breast fold accelerates the natural degenerative processes which cause ptosis (sagging) of the breast mound. This can cause early overall breast degeneration or can result in various implant based complications including double bubble, or more commonly, bottoming out of the prosthetic.
The transaxillary breast augmentation technique was revolutionary in that it was the first approach to successfully place implants using incisions off the breast mound. This method enters the body through a fine incision in the underarm. The incision can be hidden in a natural fold, although it is still often visible years later when the axilla is exposed. This operative procedure also allows patients to reduce the chance of experiencing complications relating to breastfeeding and nipple sensitivity. The transaxillary technique does not have degenerative effects on the breast fold or other mammary tissues. This surgery can be performed using any type of implant, although it works best with saline or smaller sized silicone prostheses. The downside is the possibility of nerve damage or injury to the lymph nodes in the underarm region and a greater chance for implant migration away from the intended site of placement. Of course, the scarring is also a consideration for many women, especially dancers, models and those who often lift their arms, exposing the incision locations.
Finally, we get to TUBA. The transumbilical approach allows women to reduce all the chances for breastfeeding and sensation complications, as well as avoid damaging the breast structure or enacting noticeable scarring. However, the potential downside of the procedure is that is can currently only be utilized with saline breast implants. Additionally, the technique is not indicated in all women, since individual anatomical concerns may preclude some women as ideal candidates. However, these events are rare and most women will truly benefit from this option when considering surgical breast enlargement.
In conclusion, the transumbilical approach to breast implant placement gives women one more choice to achieve the look and feel they desire without risking many of the usual negative possibilities which are associated with more traditional prosthetic placement. I always recommend that women seek out a specialist in the TUBA technique, since there is simply no substitute for a trained hand and an experienced eye...
Eve Anderson, RN, CSW, is an expert cosmetic surgery nurse and a practicing social worker in the field of mind/body medicine. Additional information about Breast Implants and TUBA can be found on her website, Breast-Plastic-Surgery.Org.
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