Breast Augmentation through the Belly Button (T.U.B.A.)

TUBA (trans umbilical breast augmentation): scarless breast surgery; belly button breast surgery; band-aid breast surgery; endoscopic breast surgery.

If you would like no visible scars, a procedure performed where the post-operative discomfort is less than half of all the other methods, and the rates of complications appear to be lower than the other approaches, then the umbilical (belly button) approach is for you. We see consistently less swelling, markedly less bruising and significantly more rapid patient recoveries. Over 90% of our patients are back to work within one week and back to full activities with no restrictions in three weeks. Although published statistics are not yet available, our experience has shown much lower rate of bleeding also known as hematoma, less hardening, lower infection rates and less sensation loss.

Why are all the problems reduced and the recovery easier and shorter? Simply stated, this approach is performed endoscopically. Just like the modern forms of knee surgery, gall bladder surgery and many other surgeries performed today, with small incisions and using scopes and cameras, there is much less trauma to the body.

Endoscopic breast augmentation through the belly button uses only one tiny incision instead of two incisions. There is virtually no cutting after the incision. Because of this there is almost no blood loss, the average being one or two teaspoons. With less cutting and less bleeding there is also less swelling. With less bleeding, bruising and swelling there is less pain after the procedure. Because there is less pain, swelling and bruising, there is a more rapid recovery and fewer complications.

Women that have not yet completed their child bearing and breast feeding can feel more comfortable that this approach is less likely to effect their ability to breast feed. This is because there is absolutely no cutting of any breast tissue. The implant and pocket for the implant are created from below and under the breast. The breast tissue is not cut or disturbed.

The Procedure:

A small incision is made inside the belly button.

A tunnel is created directly under the skin and through the subcutaneous fat.

The tunnel is extended under the breast tissue or under the pectoralis muscle (creating the pocket for the implant).

The pocket is shaped using a tissue expander that is passed up the tunnel and into the pocket by stretching the tissues.

The empty implant is rolled into a thin shape and passed up the tunnel after removal of the expander.

A fill tube attached to the implant is used to fill implant with sterile salt-water (saline).

The fill tube is removed and the implant valve is self sealing similar to a volley ball.

The T.U.B.A. was invented by Dr. Gerald Johnson, and was first performed in October, 1991. Since that time, Dr. Johnson has performed more than 4,000 T.U.B.A. procedures on more than 8,000 breasts.

The T.U.B.A. procedure takes only about 20 minutes of surgery time to perform in most cases. Each procedure is recorded with both external and endoscopic video equipment, and each patient is given a take-home video copy of her surgery.

The following is an overview of the T.U.B.A. Procedure:

1.) Prior to surgery, the patient is marked for the implant pocket dissection area and for the path the endoscope will follow during the procedure. The incision is made inside the belly-button as shown by the small inset in the illustration to the left.

2.) Once the incision has been made, some initial undermining is done to allow for insertion of the endotude.

3.) The endotube is advanced to a point beneath each breast which creates a tunnel from the belly-button to the point the pockets will be created at each breast.

4.) This sectional view shows the endotube position relative to the breast and the muscle. Dr. Johnson recommends that the implants be placed above the muscle, but Dr. Johnson also performs sub-muscular placement of the implants via the T.U.B.A. procedure.

5.) The endoscope is used to inspect the tunnels created and assure that the pocket for the implants will be dissected above the muscle.

6.) The tissue expander is rolled up such that it can be passed through the tunnel from the belly-button to the point where the pocket is to be created beneath the breast tissue.

7.) By use of the endotube, the tissue expander is put into position beneath the breast tissue.

8.) The tissue expander is inflated to about 1.5 times the desired volume for the implant by use of a fluid pump, thereby causing the separation of the breast tissue from the underlying muscle and creating the pocket into which the implant will be placed. The tissue expander is then deflated and removed.

9.) The implant is then rolled up so that it can be passed through the tunnel from the belly-button to the pocket beneath the breast tissue.

10.) The implant is placed in the end of the endotube, which will be used to push the implant up the tunnel and into the pocket at the breast.

11.) The implant is placed into position in the pocket beneath the breast tissue.

12.) The implant is then filled to the proper volume with a saline (saltwater) solution, using a syringe to assure accuracy.

13.) The implant fill tube is then removed and the implant is left permanently in place.

14.) Finally after the implants for both breasts have been filled and the fill tubes removed, the incision in the belly-button is sutured closed using disolvable sutures. The patient is wrapped in a pressure bandage and is allowed to go home.

Copyright by Dr Gerald Johnson who developed and popularized this technique.

Other names for this procedure include:TUBA, belly-button breast augmentation, band-aid breast augmentation, scarless breast augmentation, naval breast augmentation, transumbilical breast augmentation, belly button breast surgery, band aid breast surgery, scarless breast surgery, transumbilical breast surgery, naval breast surgery.