TRANSUMBILICAL BREAST AUGMENTATION
Transumbilical Breast Augmentation (TUBA) is an advanced, outpatient procedure which enhances the shape and size of breasts. TUBA is initiated through a small incision at the rim of the navel. This minimally invasive technique requires less recovery time than traditional breast augmentation methods and leaves virtually undetectable scars at the incision point and no scars around the breast. General anesthesia is most commonly used, in which patients experience no pain. The complete surgery usually ranges from 45 to 60 minutes long, and patients can return to the comfort of their homes the same day.
Prior to surgery, the doctor will draw markings from the incision spot to the implant location. The markings will indicate where the tubing will be inserted under the skin as well as the dimensions for the implant pocket and the expansion of the breast.
The surgical incision, made inside the navel, is about an inch to an inch and a half long. The elasticity of the abdominal skin helps prevent the incision from stretching, making it even less noticeable.
Once the incision is made, an endotube is inserted diagonally through the navel under the skin and fatty tissue to below the breast mound. This creates a tunnel for the insertion of the implants. Both sub-pectoral and sub-glandular placements are possible with TUBA. For sub-pectoral placement, the endotube is inserted further under the pectoral muscle. Placing the implant here results in a more natural slope of the breast.
The endotube is removed after the tunnels are successfully created. The doctor will then insert a tissue expander. The sides of the expander are rolled up to easily fit in the endotube, and a long fill tube is attached to the valve which will inflate the tissue expander.
The tissue expander is then pushed through the endotube and is situated where the implants will be placed. The expander is filled with saline using an electric liquid pump or a large syringe for either saline or air.
Depending on the placement of the implant, the breast and connective tissues will slowly separate from either the underlying muscle (sub-glandular) or from the chest wall (sub-pectoral) due to the expansion of the tissue expander, filled to approximately 1 ½ times the desired end volume.
Manual compression may also be done by pushing the implant to each side of the pocket, creating an oversized pocket, necessary for natural movement. Once the tissue has been successfully expanded, the expander is deflated and removed.
The doctor will then insert a long fill tube into an empty breast implant which is rolled up in the same manner as the expander. The implants are inserted into each end of the endotubes and are positioned in the pockets.The predetermined amount of sterile saline is injected into the implant using a large syringe.
You will be elevated to a sitting position after the implants are inserted to check for symmetry and placement. The fill tubes are then removed, the implant valves are sealed, and the incision is closed with sutures, which will be removed within 5 to 7 days. A small latex or silicone drain or tube may be inserted for 1-3 days and will be removed at your first post-operative check-up, but in most cases, this is not necessary. Depending on the needs of the patient, post-operative garments such as surgical bras or ace bandages may be worn.