Many doctors not certified by the American Board of Plastic Surgery are taking quick weekend courses about breast augmentation, including the through-the-navel method, and then just doing it. It is even possible for a patient to die from any type of anesthesia and any kind of surgery. Every person should check out the qualifications of the surgeon and anesthesiologist.
Proper training to do the TUBA method is involved, extensive, and time-consuming. A more complete discussion of why not all Plastic Surgeons know how to do the TUBA method can be found at: Few surgeons.
Because TUBA is actual surgery, possible complications include bleeding, infection, and poor healing, and occur in well below 1 percent of patients. In addition, there is the possibility of interference with the sense of touch in the nipples. These are not at all likely after any breast augmentation, but they are even less likely after the prepectoral navel approach because there is no cutting in the breast to make the space for the implant. Therefore there is less bleeding, and an even lower chance of infection with the navel method than with the other incision sites used for breast augmentation. In addition, there is less interference with the sense of touch of the nipples when the belly-button method is used. Here is some information about the possible complications that may occur.
Bleeding: A few ounces of blood can build up around the implant inside the pocket, making that breast swell and feel more engorged and painful. This is called a "hematoma" and requires a return to the operating room, to rinse everything out, and insert a drain tube, which can be removed in the office a few days later. To decrease this possibility, my patients are given a long list of medicines that may cause bleeding, which they should avoid for several weeks. The list includes Vitamin E, aspirin, herbals, nicotine, and about 100 other drugs. Many women have been fortunate and had no excess bleeding even though they had not complied with these instructions, but their chances of problems were higher. Also, at the time of the original operation, if there were more bleeding than expected, a small drain tube could be inserted as a precaution. Bleeding is less with the pre-pectoral TUBA technique, that is inserting implants in front of the muscle through the navel, than with other methods of inserting implants, probably because the pocket is created by hydraulic expansion rather than by cutting, therefore bleeding is minimal.
Infection: Infection is even more rare than bleeding. Bacteria are present in everyone's skin pores, hair follicles, and breast ducts. The operative area will be thoroughly cleaned with antiseptic before surgery (and also I give antibiotics just before, during, and after operation) but there is no way to get rid of every bacteria that could get released from your pores. Your body itself must remove any bacteria. That is why infection is more likely if there is any nicotine in the system. Many women have successfully had surgery without stopping nicotine, but they did increase their chance of infection by several times. If there is an infection, then there will likely be a return to surgery, and the implants usually (but not always) need to be removed, left out for several months, and then new implants put in at a third surgery. (Implants should not be re-sterilized, so new ones are needed) Obviously, although rare, infection is a big deal, requiring three operations, three recoveries, and three expenses. I tell patients that if their circumstances could not cover an expense almost three times the expense of having the surgery in the first place, they may want to reconsider their decision to have breast enlargement.
The chance of losing the sense of touch in the nipples is around 1 in a 100. Nationally published Journal studies have shown that there is a lower chance (0.8%) of loss of touch with the in-front-of-the-muscle through-the-navel method than with the other methods. But any woman can lose the sense of touch in her nipples, from just about any kind of breast surgery.
In the medical journals, there are articles discussing the fact that the TUBA method has a very low rate of complications, and my own experience has corroborated that. I recently prepared for medical journal publication a review of all my patients for whom I did the TUBA procedure, about 1080 patients as of May 26 of 2005. For those who may be interested, here are the data for all 1080 of my tuba patients (769 over the muscle since 1993, 311 under the muscle since 1999):
(Note that I and many other plastic surgeons do not consider either late implant failures or capsule contractures after two months as "complications" of operation.)
Types of complications as could be seen after any type of breast augmentation:For completeness, although unfavorable healing is not considered a complication, here are those cases as well.
Unfavorable healing:Is it possible that complications may have occurred in patients who didnt tell me? Patients who went to other plastic surgeons for treatment of complications but never told me and the surgeon never informed me? That certainly is possible, although the fact that I give my patients one year of free followup, and the fact that every patient has signed their willingness to keep their followup appointments make it unlikely. But if any surgeon out there has treated any of my patients for complications, I would like to be so informed, and I will then revise the above statistics accordingly.
Complications, although rare, are important, because they add expense, pain, and recovery time. Insurance does not usually cover the cost of the expenses, nor does the manufacturer of the implants. All plastic surgeons get paid for their time in operating on complications and re-dos, but there are two different ways these expenses are handled. Some plastic surgeons charge every patient a higher fee, so that the patient who actually has a complication or needs a re-do does not need to pay for it. If the extra fee charged every patient is high enough, then the patient with the complication does not even have to pay for the operating room. The other plastic surgeons (including me) do not make every patient pay extra to help out the rare person who has the complication, and so only the patient who actually has the complication or needs a re-do incurs the expense.
The reason for my philosophy is that I consider it unfair for everyone to pay a higher fee, when only a few patients are going to have complications, which in most cases are due to random chance, but in many cases are due to that patient failing to follow instructions, such as not discontinuing nicotine, or failing to do other pre-operative preparations or follow postoperative instructions. I do not charge a higher fee for every patient, and only the patient who has the complication pays for it.
It is highly significant to look at the statistics from surveys done among women with implants. Not only do national surveys reveal that 97 or 98 percent of women with implants would do it again, but also that even most of those few patients who have experienced the rare complications would still do it again!
Keywords: Breast implants through the navel; Transumbilical breast implants; Belly-button breast implants; Through-the-navel breast enlargement; Through-the-navel breast augmentation; Trans-umbilical breast augmentation; Trans-umbilical breast enlargement; Belly-button breast enlargement; Belly-button breast augmentation; Breast enlargement through the navel; Breast augmentation through the navel; Navel breast enlargement; Navel breast augmentation; 'Scarless' breast enlargement; 'Scarless' breast augmentation.