{{Use dmy dates|date=September 2020}} {{Infobox medical intervention | name = Trans-umbilical breast augmentation | synonym = | image = | caption = | alt = | pronounce = | specialty = plastic surgery | synonyms = | ICD10 = | ICD9 = | ICD9unlinked = | CPT = | MeshID = | LOINC = | other_codes = | MedlinePlus = | eMedicine = }} '''Trans-umbilical breast augmentation''' ('''TUBA''') is a type of [[breast augmentation]] in which [[breast implant]]s are placed through an incision at the [[navel]] rather than the chest.<ref name="SpearWilley2006">{{Cite book |first1=Scott L. |last1=Spear |first2=Shawna C. |last2=Willey |first3=Geoffrey L. |last3=Robb |title=Surgery of the Breast: Principles and Art |url=https://books.google.com/books?id=cYGaj7GYstgC&pg=PA1319 |accessdate=7 August 2010 |year=2006 |publisher=Lippincott Williams & Wilkins |isbn=978-0-7817-4756-1 |page=1319}}</ref>
==History== In 1964, the American [[Plastic surgery|plastic surgeons]] T.D. Cronin and F.J. Gerow reported the first breast augmentation procedure using silicone gel-filled implants.<ref name=one/> In that implantation procedure, the breast implant devices were inserted through an incision to the [[inframammary fold]] (IMF), where the [[breast]] meets the chest of the woman.
In 1972, J. Jenny described a periareolar-incision emplacement technique for inserting the breast implants via an incision under the [[areola|nipple-areola complex]] (NAC).
In 1973, Koeller described a transaxillary [[breast implant]] emplacement technique effected by means of an incision to the [[axilla]].<ref name=two/>
In 1991 the trans-umbilical breast augmentation was invented and first performed by Dr. Gerald W. Johnson in Houston Texas. T.U.B.A is a technique for the implantation of [[Breast implant|saline breast implants]] through a small incision at the woman's navel. The trans-umbilical emplacement approach is a technical variant of the abdominal tunnel technique employed for inserting breast implants, which was described in 1976, which facilitated the inserting and emplacing of empty saline implants to the breast-implant pocket.<ref name=four/><ref name=five/><ref name=six/>
==Surgical technique== A trans-umbilical breast augmentation is a [[breast implant|breast prosthesis]] insertion technique wherein the incision is at the [[Navel|umbilicus]] (navel), which dissection then tunnels superiorly, to facilitate emplacing the breast prosthesis to the implant pocket without producing visible surgical scars upon the [[breast]] hemisphere; but it makes appropriate dissection and device-emplacement more technically difficult. A TUBA procedure is performed bluntly (without [[endoscope|endoscopic]] assistance), and is inapplicable to emplacing (pre-filled) silicone-gel implants, because of the great potential for damaging the [[elastomer]] silicone shell of the breast-implant device during its manual insertion through the short, two-centimetre (3/4"), incision at the navel, and because pre-filled silicone-gel implants are incompressible, and cannot be inserted through so small an incision.<ref name="johnson"/>
;Advantages The scar is produced in a remote location (the navel).
;Disadvantages The TUBA (Trans-umbilical Breast Augmentation) approach is inapplicable for the emplacement of incompressible, pre-filled breast implants, usually of the silicone-gel-filled variety.<ref name="pmid20567689"/> There is felt to be somewhat less precision with this approach in developing the breast pocket as compared to traditional incisions. Future surgeries or difficulties encountered during the initial surgery likely need to be addressed through a different incision.
==See also== * [[Breast]] * [[Breast augmentation]] (Augmentation mammoplasty) * [[Breast reconstruction]] * [[Mammoplasty]] * [[Mastopexy]] (breast lift)
==References== {{Reflist |refs= <ref name=one>{{cite book |last1=Cronin |first1=Thomas D. |last2=Gerow |first2=Frank J. |year=1964 |chapter=Augmentation mammaplasty: a new 'natural feel' prosthesis |pages=41–9 |title=Transactions of the Third International Congress of Plastic and Reconstructive Surgery |oclc=82436969}}</ref> <ref name=two>{{cite journal |last1=Jenny |first1=H |title=The Areolar Approach to Augmentation Mammaplasty |journal=International Journal of Aesthetic Plastic Surgery |year=1972}}{{page needed|date=October 2014}}</ref> <ref name=four>{{cite journal |last1=Planas |first1=J |year=1976 |title=Introduction of breast implants through the abdominal route |journal=Plastic and Reconstructive Surgery |volume=57 |issue=4 |pages=434–7 |pmid=131947 | doi = 10.1097/00006534-197604000-00003 |s2cid=27018439 }}</ref> <ref name=five>{{cite journal |last1=Pound |first1=Edwin C. |year=2000 |title=Trans-umbilical breast augmentation (TUBA): Technique for pre-pectoral and post-pectoral placement of implants |journal=Operative Techniques in Plastic and Reconstructive Surgery |volume=7 |issue=3 |pages=116–24 |doi=10.1053/otpr.2000.21108}}</ref> <ref name=six>{{cite journal |last1=Pound |first1=EC III |last2=Pound |first2=EC Jr |year=2001 |title=Transumbilical breast augmentation (TUBA): Patient selection, technique, and clinical experience |journal=Clinics in Plastic Surgery |volume=28 |issue=3 |pages=597–605 |doi=10.1016/S0094-1298(20)32399-3 |pmid=11471965}}</ref> <ref name="johnson">{{cite journal |last1=Johnson |first1=Gerald W. |last2=Christ |first2=John E. |year=1993 |title=The Endoscopic Breast Augmentation |journal=Plastic and Reconstructive Surgery |volume=92 |issue=5 |pages=801–8 |pmid=8415961 |doi=10.1097/00006534-199392050-00004}}</ref> <ref name="pmid20567689">{{cite journal |last1=Dowden |first1=Richard |year=2008 |title=Transumbilical Breast Augmentation is Safe and Effective |journal=Seminars in Plastic Surgery |volume=22 |issue=1 |pages=51–9 |pmid=20567689 |pmc=2884857 |doi=10.1055/s-2007-1019143}}</ref> }}
{{Breast procedures}}
[[Category:Breast surgery]]