I have been doing this special technique since 1992, and have found it to be an excellent method, with extremely few complications, and very high patient satisfaction. I expect more Plastic Surgeons will eventually learn the technique, but as the training and equipment are expensive, it is understandable why many Plastic Surgeons don't want to bother learning how to do it.
It is well-established that the chance of complications is lower with the transumbilical method than with any other method, and also there is less pain and a quicker recovery. Probably, the reason is that there is no cutting done in or behind the breast, but rather the pockets are made by expansion.
In June of 2000, for the first time in nearly 40 years of breast implant use, the FDA gave official government approval of implants. However, that approval did not include the endoscopic methods. The manufacturers wanted to include the transaxillary (underarm) and transumbilical (TUBA) method in their brochures, but those methods were not included in the data submitted to the FDA to get implants approved. Because they did not submit the data, they were not permitted by the FDA to recommend those or any endoscopic method in their brochures.
In fact, the FDA panel forced the manufacturers to recommend against ALL endoscopic methods, regardless of incision location, including the axillary (underarm) method as it is usually done. The upshot of this is that most plastic surgeons will continue doing the procedures just as they have been doing all along. Most people are just glad that the FDA finally gave implants any approval at all, after nearly forty years of their being used without any FDA approval whatsoever!
Many people are not aware that in the USA there is a serious problem in the world of plastic surgery: non-qualified doctors can call themselves plastic surgeons even though they are not. This is certainly a problem with all types of breast augmentation, which are currently being done by dermatologists, gynecologists, general surgeons, ear-nose-and-throat doctors, chiropractors, cardiac surgeons, and dental/oral surgeons, all of whom are legally allowed to call themselves plastic surgeons! The majority of very difficult corrections of poorly-done breast augmentations that I have been called upon to correct have been done by such non-plastic surgeons. The reason for mentioning this here is that to many of these practitioners, the TUBA procedure appears very easy, and many of these non-plastic surgery specialties offer quickie weekend courses in the TUBA method. The result is that in the USA many TUBA procedures are done by non-plastic surgeons, often with sub-standard results. Something to think about.
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