Breast Augmentation: Cost, Reviews, Photos

TUBA (transumbilical breast aumentation) places breast implants through a tunnel from your belly button to the breast. It can place the implants on top of the muscle, or with more difficulty, under the muscle.

I learned TUBA breast augmentation from the developer of the procedure, Dr Gerald Johnson. I did numerous cases and can make the following generalizations.

Bleeding and positioning aren’t usually problems, There are size limitations with submuscular implants. Certain body types of patients can be very challenging to dissect.

While I think it is amazing that the implants can be placed in this fashion, I generally prefer axillary placement of the implants. (Daryl K. Hoffman, MD, Los Gatos Plastic Surgeon)

It is possible to put the implants below the muscle with TUBA breast augmentation approach, however it is important you find an experienced board certified plastic surgeon who specializes in this technique.

It is very difficult to position the implants via TUBA breast augmentation, and even more difficult when placed sub muscularly. (Jerome Edelstein, MD, Toronto Plastic Surgeon)

TUBA breast augmentation can be used to put saline implants under the muscle. This is actually the best outcome when performing TUBA breast augmentation. The results are consistent, the incision tiny. Most patients who have this done are very happy with the results, it provides more coverage over the implant than submammary. I agree that a down side is that silicone implants can not be used with this approach, so if you want silicone, you would have to have a incision on each breast (Laura A. Sudarsky, MD, Fort Lauderdale Plastic Surgeon)

TUBA breast augmentation

I think that there is evidence in the literature to suggest that saline implants can be placed under the muscle using the TUBA technique with good results. I personally do not use the technique because I have not had a reason to do so. The most obvious reason to consider the TUBA technique is to avoid a visible scar. The fact is that breast augmentation using more traditonal techniques, if done thoughtfully and carefully, results in a very well disguised scar. I know that in my hands, the best result is going to be using an IMF crease incision. If you wish to use the TUBA breast augmentation approach, find a board certified plastic surgeon that is open and honest about his results and complications. (William T. Stoeckel, MD, Raleigh-Durham Plastic Surgeon)

TUBA (Trans Umbilical Breast Augmentation) is a novel operation for placement of saline implants above or under the muscle.

The ideal candidate for this procedure is any patient that would be a good saline candidate. The only two drawbacks of this procedure are”

1: limited to saline implants

2: a VERY steep learning curve

An experienced board certified plastic surgeon who has done many of these procedures can give you excellent results without a visible scar. I have even performed reoperations through the navel to exchange a deflated implant with this approach.

If you are a saline candidate (in my practice thats someone who wants a moderate (less than 2cup) size increase and may have some size assymetry), find the best board certified TUBA surgeon near you, ask them how many they have done, if the answer is more than 100, do it with them. (Kevin Tehrani, MD, FACS, New York Plastic Surgeon)

There are surgeons who report using this technique to place the implants under the muscle. the truth is, the further your incision is from the area that you are operating on, the less control you have. breast implant surgery is all about controlling the pocket.

Again, if you are operating from an incision far away from the breast, you have very little control. For those who desire breast augmentation under the muscle with an incision off of the breast, i would recommend a transaxillary approach. the scar is well hidden, and again, off of the breast. (Eric Chang, MD, Baltimore Plastic Surgeon)

TUBA or transumbilical breast augmentation is the least used method for breast augmentation. I cannot endorse it and have seen many complications from other surgeons.

There is very little control of the pocket for the implant and as it is almost a blind procedure, there are more risks of bleeding, asymmetry, etc. It is nearly impossible to place a breast implant in the submuscular position by the TUBA method. Do not be fooled by slick advertising methods.

Most surgeons who advertise this method with switch you to another surgical approach. Breast Augmentation can safely be done with low complication rates and a small scar underneath the breast, or through the edge of the areola, or with the aid of an endoscope through the underarm or axilla. (Leo Lapuerta, MD, Houston Plastic Surgeon)

Transumbilical breast augmentation can be performed under the muscle. Transumbilical breast augmentation is designed to use saline implants since silicone implants would be essentially impossible to place via the belly button. When saline implants are placed, regardless of the incision used, they should be placed under the muscle for the best result. The benefit of the transumbilical breast augmentation is that there is a small incision and it is in the belly button. The negative is that the TUBA procedure offers the least amount of control to the plastic surgeon. (Remus Repta, MD, Scottsdale Plastic Surgeon)

Transumbilical breast augmentation under the muscle

Transumbilical breast augmentation under the muscle is possible but I am not a big fan. I think you get a better result with precise definition of the infra-mammary fold ( fold under the breast) with a more traditional incision. Ultimately these incisions are typically quite imperceptible. (Talmage J. Raine, MD, Champaign Plastic Surgeon)

A sub-muscular placement is possible with a TUBA approach. But my concern at the moment with the TUBA technique is how one would control arterial bleeding if you do place the implant under the muscle. Invariably, you would want to release the pectoralis muscle at the inferior border and would most likely avulse some small arteries (perforators) that would be difficult to control. (George Min, MD, Bellevue Plastic Surgeon)

I personally think that a transumbilical breast augmentation is an operation that should not be done as it has significant inherent risks. There are much more risks than benefits and is something that has had significant morbidity. I do not recommend it as there are far more accessible routes to perform breast augmentation. These include transaxillary (armpit incision) as well as inframammary fold. These provide for more optimal results, as well as correction of asymmetries. In most cases, the breast implant companies in the U.S.A. will not insure an implant that is placed through a transumbilical approach because this is done via a blind technique. (Rod J. Rohrich, MD, Dallas Plastic Surgeon)

You should, as with any other procedure, be sure that you go to a board-certified plastic surgeon who’s experienced in the technique(s) you’re interested in. Implants can, in general, be placed in the submuscular position even via a TUBA technique.

As you probably know, you’ll need to opt for saline filled implants (rather than silicone gel) if you want TUBA. I hope that this helps, and good luck, Dr. E (Alan M. Engler, MD, FACS, New York Plastic Surgeon)

I also am not a large proponent of this procedure, while it leaves you with no scar on the breast it does have some concerns as far as revisions and placement. If you are set on having this procedure–I’d recommend you see Dr. Edwin Pound as he does more of these than anyone in the country to my knowledge. (Thomas B. Lintner, MD, FACS, Atlanta Plastic Surgeon)

Transumbilical breast augmentation risks and benefits

I am not a proponent of tis procedure due to its limitations including difficult access to the sub muscular plane, higher incidence of improper placement and limitation to saline implants. Be sure to weigh the benifits of perhaps a less noticeable scar with these issues.

Be sure that any surgeon who does a TUBA is familiar with the more traditional inframammary or areolar incisions so that in case an issue arises he or she is capable of fixing the problem, which may be difficult to do.

As with any surgery it is best to do it right the first time rather than try to fix it. (Terrence Murphy, MD, Englewood Plastic Surgeon)

Trans umbilical breast augmentation – Breast Implants through the belly button

Trans umbilical breast augmentation is performed by making an incision around the belly button and tunneling the implants up to the breasts.

It is not approved to be performed with silicone implants and therefore, this technique is reserved for saline implants.

In addition, the rate of complications and lower of level of patient satisfaction with this technique even in the most experience hands results in few qualified plastic surgeons offering this procedure.

Although it may seem attractive, the majority of scars through the inframmamary, periaoreolar, and axillary incisions fade with time. In addition, all revision breast implant surgery requires an incision on the breast.

Trans umbilical breast augmentation is, therefore, more of a marketing tool than a recommended option for most women. (Ankit Desai, MD, Jacksonville Plastic Surgeon)

You can place implants under the muscle. The problem with the trans umbilical breast augmentation is that it is a blind operation. In order to get consistent results, the surgeon should be able to see the dissection of the muscle. This is impossible in the trans umbilical breast augmentation, the muscle is literally torn in a blind fashion. For a minimal scar operation I prefer the trans-axillary approach. Using an endoscope I can clearly visualize the muscle and be very precise with the dissection. Furthermore, using the “Keller Funnel” I can place the new memory gel implants through the armpit incision. Something that is impossible with the trans umbilical breast augmentation. (Jose M. Soler-Baillo, MD, Miami Plastic Surgeon)

This method of augmentation has been marketed as being nearly scar-free. However, as you know, what is marketed and what is reality are two different things. I don’t perform this procedure due to the high rate of complications and long term poor outcomes.

In general, this technique places implants in the subglandular plane (just under the breast). This increases the risk of capsular contracture and visible rippling. I have performed revisions on implants placed via this manner more than any other. I have seen implants placed in the submuscular plane via this technique, but it often traumatizes the muscle. Due to the blind nature of the technique, I have also seen implants placed partially submuscular as well as submuscular on one side and subglandular on the other. If you are concerned with a breast scar, transaxillary placement, in my opinion, is far superior to the trans umbilical breast augmentation. (Jason R. Hess, MD, San Diego Plastic Surgeon)

Trans umbilical breast augmentation is a blind and blunt procedure which likely places the implant under the breast glandular tissue though there is no way to confirm this. As a plastic surgeon doing the procedure once should tip you off that this is not a good procedure and likely leads to a high rate of breast implant malposition, scarring, and revisions. Breast augmentation should have a high degree of precision with a low complication and revision rate.

Don’t play games with your breasts when it comes to breast augmentation. Do it once the right way and you will be happy for years. (Andrew P. Trussler, MD, Austin Plastic Surgeon)

Because you can doesn’t mean you should

Yes, you can use the breast augmentation tuba approach for submuscular implants.

But you should do more research on the pro’s and con’s of each approach before you make a final decision. Every technique has some advantages/ disadvantages.

Only you can decide if having a scar around your umbilicus, instead of approximately a one inch scar under your breast, is worth the trade offs.

If you do decide on the TUBA approach, I would see a surgeon very experienced with that technique. (Dean Fardo, MD, Atlanta Plastic Surgeon)

TUBA refers to transumbilical breast augmentation. Yes, the implant can be placed under the muscle this way.

But, it is very difficult to maintain control of the pocket if there is bleeding. You also can not place gel implants this way. (Steven Wallach, MD, Manhattan Plastic Surgeon)

The breast implants, and only saline breast implants in the case of TUBA, can be placed either above or below the muscle. (Edmond A. Zingaro, MD, San Francisco Plastic Surgeon)

Transumbilical breast augmentation

Compared to other approaches for breast augmentation, the breast augmentation tuba suffers from the following disadvantages:

1. The need for an alternative approach (incision) for revisionary surgery.
2. The need for a second incision when this is combined with any type of mastopexy, or breast lift.
3. It does not allow for the use of silicone gel implants. This significantly reduces the options a patient has, and increases the risk of implant rippling for those patients at risk for this complication.
4. It is difficult to correct breast asymmetries with this approach.
5. It may void the warranty on saline implants, due to trauma to the implant shell.
6. Minimal control of the pocket dissection.
7. Poor visualization of the operative field. For all of these reasons, the TUBA is not a first choice operative technique for qualified plastic surgeons. (Glynn Bolitho, PhD, MD, FACS, San Diego Plastic Surgeon)

Avoid the breast augmentation tuba, use transaxiallry for beautiful results

I would strongly recommend staying away from breast augmentation tuba. The reality is that in very experienced hands the implant may be above, partially through in or under the muscle.

Only saline implants are placed which means for these two reasons your breasts will not be ideal and with the limited control the surgeon has, partially up to cahnce. Breast augmentation tuba can be a reasonable choice for a patient with perfect breast, nipple and chest wall morphology, but these patients are rare.

To get a nice breast augmentation result, customization of the procedure to the patient is necessary and is nearly immpossible with breast augmentation tuba. I dont like scars on the breast either which is why I routinely use atransaxillary (under armpit) subfascial approach to give my patients natural appearing results. I strongly suggest that you look into transaxillary subfascial placement. (Rian A. Maercks, MD, Miami Plastic Surgeon)

In my opinion, the breast augmentation tuba is much ado about nothing. Therefore, a don’t do it. But the implants can be placed above or below the muscle. (Vincent N. Zubowicz, MD, Atlanta Plastic Surgeon)