Transumbilical Breast Augmentation

By Jerome Edelstein, MD

Transumbilical breast augmentation is different from other forms of breast augmentation, in that it doesn’t require an incision made either around the areola (periarolar), under the breast (inframammary) or within the armpit (transaxillary). Rather, the incision for transumbilical breast augmentation is made at the navel. Once the small incision is made, a small path is cut under the skin toward the breasts to allow for the insertion of a long flexible tube called an endoscope. The breast implants are positioned in the chest via this tube. While it is easier to place the implants over the muscle using this method, it is also possible (although much more difficult) to place them under the muscle if desired.

The primary benefit for the transumbilical incision is the minimal visible scarring. The scar is short, often just one to two centimetres long, and it is placed within the navel, far from the breasts. For most patients, however, the limitations and difficulties of a transumbilical breast augmentation will outweigh the reduced scarring.

THE CONS OF TRANSUMBILICAL BREAST AUGMENTATION

Only saline implants:Another drawback of transumbilical breast augmentation is the length of the incision. Because it is so short, only a saline implant shell can be placed, which is then filled after it is positioned in the body. This limits your choice of implants. Silicone cohesive gel implants are too large to go through the endoscope without sustaining damage. Saline breast implants tend to be less natural-feeling than cohesive silicone gel implants and also increase the risk of visible rippling, particularly when placed over the muscle.A different approach is necessary with revision surgery:A final negative point is that surgical corrections are almost impossible to perform with the transumbilical approach. Any revision surgeries to correct placement, excessive internal scarring, rippling, rupture or for replacement must often use a different approach, which require a more extensive incision.

Ultimately, the choice of incision placement comes down to the patient’s individual priorities for a breast augmentation. However, the transumbilical approach is often not recommended due to its difficulties in achieving natural, satisfying results.