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Transumbilical Breast Augmentation (TUBA)

These are frequently asked questions (FAQ) about transumbilical breast augmentation (TUBA) surgery. If you have a suggestion for any additional questions, please let us know.

What does TUBA stand for? What is the difference between a TUBA and a traditional breast augmentation?
Is TUBA FDA approved?
I have heard that the TUBA procedure is scarless. Is it this true?
Can I have breast implants placed behind (under) the pectoral muscle with TUBA?
I have heard that visible tracks can be seen after TUBA. Is this true?
If I have a rupture, can I have my breast implants replaced through the navel?
Can I have a breast lift and TUBA?
Can I get silicone gel or cohesive silicone gel breast implants with TUBA?
I’ve heard the risk of infection is reduce with TUBA. Is this true?

1. What does TUBA stand for? What is the difference between TUBA and a traditional breast augmentation?

TUBA stands for transumbilical breast augmentation. With traditional breast augmentation techniques, the incisions are made either in the crease underneath the breast (inframammary), around the darker skin surrounding the nipple (periareolar), or in the armpit (transaxillary).

With transumbilical breast augmentation, a short J or C-shaped incision is made within the umbilicus or navel (belly button) and empty saline breast implants are moved into place using endoscopy, where the surgeon sees what he or she is doing with a tiny camera and fiber optics. After the breast implants are in place, they are filled with sterile saline to the desired size. The milk ducts in the nipple are not disturbed with a TUBA and recovery time can be half the time of traditional methods. The scar of the incision is hidden within the folds of the navel.

2. Is TUBA FDA approved?

The job of the U.S. Food and Drug Administration (FDA) is to approve drugs and medical devices such as breast implants for use in the United States. It does not approve or evaluate surgical techniques. When breast implants were pulled off of the market for a period of time, the FDA required implant makers to submit data on their products based on transaxillary, periareolar, and inframammary insertions. At the time, few surgeons used the transumbilical breast augmentation technique and no data on it was submitted. But the FDA was only looking at the safety of the breast implants, not of routes of insertion.

However, the 2004 edition of the FDA Breast Implant Consumer Handbook notes that the transumbilical incision site is not recommended by implant makers. This is true. Neither Mentor nor Allergan, the two makers of FDA-approved breast implants officially recommend a transumbilical insertion for any of their products.

That said, once the FDA approves an implant, a surgeon can use any insertion technique her or she wants. There are many qualified, board-certified surgeons who perform transumbilical breast augmentation. As with everything in medicine, there is a period of time before a specific surgical technique catches on.

3. I have heard that the TUBA procedure is scarless, it this true?

The TUBA technique is considered scarless because the incision is hidden within the navel camouflaged by the natural folds. With traditional techniques, the breast implant scars can be visible underneath the breasts, around the areola, or underneath the arms, although some patients' scars with periareolar and transaxillary techniques are practically invisible postoperatively.

4. Can I have breast implants placed behind (under) the pectoral muscle with TUBA?

Yes. You have the option of having your breast implants placed partially underneath the pectoralis major muscle with transumbilical breast augmentation. Although some doctors may say that it can't be done, that may be because they don’t do it. We know many patients who have received under placement with the TUBA approach.

5. I have heard that visible tracks can be seen after TUBA. Is this true?

With transumbilical breast augmentation, the surgeon makes the incision in the navel and then, using endoscopic equipment, creates two tunnels (one to each breast) just under the skin through which he or she places the implants, which are then filled. The tissues along the tunnels will usually adhere again and no visible trace is found after healing. In rare instances, the tissues do not adhere and you may be able to see tracks postoperatively.

6. If I have a rupture, can I have my breast implants replaced through the navel?

Yes, usually. There is no reason to have additional scars for the replacement of an uncomplicated ruptured saline breast implant. The incision will be made at your original incision, and the breast implant can be removed and replaced. The replacement operation usually involves less pain that the original, since most of the pain is due to the creation of the implant pocket and tissue expansion. This goes for both over and under placement.

7. Can I have a breast lift and TUBA?

It would not make sense to have a transumbilical breast augmentation if you are having a breast lift. In most breast lifts, there is excess skin removed and incisions around the nipple or below the breasts will be made. There would be no need for an additional scar in the navel because even the smallest breast lift incisions can accommodate the implant.

8. Can I get silicone gel or cohesive silicone gel breast implants with TUBA?

No. Transumbilical breast augmentation uses empty silicone implants that are filled after they are moved into place. Silicone gel and cohesive silicone implants are prefilled and must be implanted via inframammary or periareolar incisions.

9. I’ve heard the risk of infection is reduced with TUBA. Is this true?

Although there is always the chance of infection with any surgery, the risk of infection is reduced with transumbilical breast augmentation because of the placement of the incision and the lack of contact between the implant and the outside skin of the breast and the milk ducts. The incision is not near the breast tissue nor is the breast implant is ever passed through the skin where staph bacteria naturally live. Bacteria are also found naturally within the milk ducts. The breast implant is passed under the skin from the navel through a tube, so it has an untainted passage into your body. If an infection occurs after surgery at the incision site in the navel, the tunnels created for insertion have usually closed or are closing and the infection is isolated in the navel area.