Transumbilical breast augmentation (TUBA) places saline implants through a small incision in the belly button, leaving no scars on the breasts themselves. Traditional breast augmentation allows silicone as well as saline implants, so the right choice generally depends on your goals, your anatomy, and your implant preference.
Deciding to have breast augmentation is a deeply personal choice, and the decisions don’t end with implant size. Where your surgeon places the incision shapes everything from the scar you’ll see in the mirror to the type of implant you can choose and how easily any future breast surgery can be performed.
At Premier Plastic Surgery & Aesthetics, board-certified plastic surgeon John Sarbak, MD, helps patients weigh these trade-offs so they can make a confident, well-informed decision. Dr. Sarbak regularly performs transumbilical breast augmentation, better known as TUBA, and he is the only plastic surgeon in the Vero Beach, FL area who offers it. Below is a breakdown of how the TUBA approach compares with traditional breast augmentation techniques and who tends to be a good fit for each.
What Is Transumbilical Breast Augmentation (TUBA)?
TUBA is a technique where a small incision is made just inside the rim of the navel. Using an endoscope (a thin tube with a tiny camera), Dr. Sarbak creates a narrow channel beneath the skin of the abdomen up to the chest, forms a pocket for the implant, and guides a rolled, empty implant into place. Once it’s positioned, the implant is filled with sterile saline.
The main appeal is simple: there is no incision on the breasts at all. The only scar sits within the natural folds of the belly button, where it is very difficult to spot.
That convenience comes with limits. Since the implant must travel a long distance through a small opening, the TUBA technique works only with saline implants. Prefilled silicone gel implants, including highly cohesive “gummy bear” styles, can’t be placed this way. The TUBA method also requires specialized training, so relatively few surgeons offer it.
What Is Traditional Breast Augmentation?
Traditional breast augmentation places the incision closer to the breast, most often in one of three locations:
- The inframammary incision sits in the crease beneath the breast and is the most widely used, since it gives a surgeon direct access and can be easily concealed by the natural fold, a bra, or a swimsuit top.
- The periareolar incision follows the lower edge of the areola, where the color change helps disguise the scar.
- The transaxillary incision is made in the armpit and, like TUBA, avoids a scar on the breast itself.
Since traditional augmentation works closer to the breast, these approaches allow precise control over the implant pocket. They can also accommodate both saline and silicone implants in a wide range of sizes, shapes, and profiles, placed either above or below the chest muscle.
How the Two Approaches Compare
- Scarring: TUBA’s biggest advantage is a breast free of scars. That said, well-placed inframammary scars typically fade over time and are rarely visible in everyday life.
- Implant choice: Traditional techniques allow saline or silicone. The TUBA approach is currently limited to saline. When the implant’s diameter doesn’t exceed the breast tissue’s diameter and the patient has a reasonable amount of breast tissue, saline implants can look very natural.
- Precision: With traditional incisions, a surgeon creates the pocket while looking from beneath the breast and matches the opposite side largely by memory and feel. With TUBA, Dr. Sarbak can watch the pocket form from both the inside and the outside, positioning each implant precisely in relation to the nipple and comparing both breasts directly. In his experience, this makes transumbilical breast augmentation the more accurate method.
- Future procedures: Breast implants aren’t lifetime devices, and many patients eventually want an exchange, a size change, or treatment for complications such as capsular contracture. Depending on what’s needed, a future revision may require an incision closer to the breast, which is worth discussing during your consultation. Placing implants through the belly button does not void the implant warranty.
- Recovery: Recovery is broadly similar. TUBA patients may feel some tightness or soreness along the abdomen where the channel was made, and most patients in either group return to light activity within about a week.
Who Is a Good Candidate for Each?
The TUBA technique may suit you if you are healthy, have a reasonable amount of natural breast tissue, are comfortable with saline implants, don’t need a breast lift, and place a very high priority on avoiding breast scars.
Traditional breast augmentation is usually the better path if you prefer silicone, want an implant wider than your natural breast tissue, need a breast lift, or are undergoing revision surgery.
Key Takeaways
- Transumbilical breast augmentation places implants through the belly button, leaving no scars on the breasts.
- The TUBA approach works only with saline implants, while traditional breast augmentation accommodates both saline and silicone.
- Dr. Sarbak has found the TUBA method to be more accurate, since he can watch the pocket form from inside and outside and compare both breasts directly.
- TUBA does not void your implant warranty, and Dr. Sarbak is the only plastic surgeon in the Vero Beach area who offers it.
- The best option depends on your goals, anatomy, and implant preference, which a consultation with a board-certified plastic surgeon can clarify.
If you’re considering breast augmentation, the best way to choose between TUBA and a traditional technique is a one-on-one conversation with an experienced, qualified plastic surgeon. Schedule a consultation with Dr. Sarbak at Premier Plastic Surgery & Aesthetics to discuss your goals and get a personalized recommendation. Contact our office today to take the first step toward a result you’ll love.