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Breast Surgery Mega-Site by Rebecca
The Original Breast Surgery Mega Site, with the Top Breast Surgeons,
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TUBA
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The TransUmbilical Breast Augmentation (TUBA) procedure was developed in the early nineties as an alternative method of placing breast implants that would leave no visible scar on or around the breast. Building on his experience of placing breast implants through abdominoplasty or tummy tuck incisions, Dr. Gerald Johnson, realized that he could use an endoscope, or the lighted tube used in other types of limited access surgeries, to tunnel just underneath the skin up to the breast area from a small incision hidden in the upper fold of the belly button. Besides eliminating scars on or near the breasts, this method allowed both breast implants to be placed through a single incision.
Initially, TransUmbilical Breast Augmentation (TUBA) breast implants were only placed under the breast tissue, above the chest muscle. As others gained experience with the TUBA procedure, surgeons realized that the implants could also be placed under the chest muscle, a modification, which is sometimes desirable in women who are thin with little breast tissue present to cover the implant.
The TUBA procedure is performed under general anesthesia similar to that used in liposuction surgery. A small incision is made in the fold of skin, which overlies the belly button (navel), so the scar will not be visible. A blunt instrument called an obturator is used to gently tunnel under the skin to the level of the breast crease. If the implant is to be placed under the breast tissue, the dissection is performed on top of the muscle in the loose connective tissue plane between the muscle and the breast tissue. If the implant is to be placed in the plane below the muscle then the dissection is carried out in the loose connective tissue plane under the chest muscle.
The endoscope is inserted to confirm the correct plane of dissection. This is followed by a breast implant sizer, which is rolled into a taco shaped roll and guided up the tunnel into the pocket created. The implant sizer is then inflated with sterile normal saline solution (physiologic salt water) to a size somewhat larger than the final implant to be placed, to allow for refinement of the dissection. The same TUBA procedure is then completed on the opposite breast, and any asymmetries are noted. The sizers are then deflated and removed. The final implants are placed in a similar fashion. The small tubes, which will allow them to be filled with normal saline, are left exiting from the navel from their respective tunnels. Small adjustments may now be performed by equalizing the breast size as much as practical by varying the amount of saline placed in each implant. The fill tube is then pulled gently out of the self-sealing valve of each implant and the valve covers seat over the valves to ensure closure. The single belly button incision is then closed with sutures, which the body will dissolve, and a light compression dressing is placed.
The average recovery time for return to normal daily activities after Trans Umbilical Breast Augmentation (TUBA) is 2-7 days for implants placed over the muscle and is 4-7 days for implants placed under the muscle. Total healing, as with all surgeries, will take six to twelve months. The patient may return to normal exercise in two to three weeks.
TransUmbilical Breast Augmentation Risks
Saline breast implants have a proven safety record, however, as with all breast implants, they are not permanent. Eventually the implant wall or valve will fatigue, and the implant will leak. Since they are filled with sterile saline, which is similar to the body's own natural fluid, the saline will be harmlessly reabsorbed by the body.
All breast implant manufacturers currently warranty their implants for life, and will replace any deflated implant that fails from normal wear and tear. If the implant fails within the first five years, they will usually pay between $1,000.00 to 1,200.00 toward replacement. It is possible to replace the implant through the Trans Umbilical approach.
Specific risks of Trans Umbilical Breast Augmentation (TUBA) breast implant surgery should be discussed in detail with your surgeon during a thorough consultation.
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TransUmbilical Breast Augmentation ~ TUBA
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TABA ~ Transabdominal Breast Augmentation
by board certified plastic surgeon, Dr. Steven Wallach, New York, NY
TABA
Breast Augmentation Photos by Dr. Steven Wallach, New York, NY
Introduction
Transabdominal breast augmentation, or TABA, is a procedure that combines a breast augmentation with a full abdominoplasty using the abdominoplasty incision to perform the breast augmentation as well. Therefore, there are no incisions placed on or near the breast!
Many prospective patients searching for breast augmentation recognize the term, TUBA. TUBA stands for transumbilical breast augmentation. TABA is different from the TUBA procedure. The TUBA is performed with a tunneling device that is placed through an umbilical incision. Tunnels are made extending to each breast. Once the tunnels are created, the breast implant pocket is balloon dissected and then the empty saline-filled implants are tunneled into the chest and inflated, most of the implants placed this way are performed in a subglandular pocket. Silicone gel implants can not be placed through the very narrow tunnels developed during a TUBA procedure. So if a patient wants silicone gel implants, another approach has to be used. The TABA procedure is very different. First, a tunneling device is not used. The pocket is created under direct vision. A submuscular or subglandular pocket can be made, and a saline or gel-filled implant can be passed easily through the tunnel.
Indications
This operation is indicated for a patient that is a candidate for a breast augmentation as well as a full abdominoplasty. In addition, a patient should be a good candidate for a breast augmentation. Therefore, the patient should not have significant breast ptosis, or sagging. If the breasts sag then a mastopexy ( breast lift) is most likely required. All breast lifts would require placing incisions on the breast, and therefore this would preclude using the TABA technique as well. This is a great procedure for select patients that want an abdominoplasty and a breast augmentation at the same time! The cumulative operative time is less and the cost is lower for the two procedures than performing the two procedures individually at separate operative settings. The recuperation time is usually about the same as recuperating for either one of the procedures alone.
Dr. Wallach has published several plastic surgery articles on this subject and also teaches a course on this subject to other plastic surgeons at the national aesthetic surgery meeting.
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