Unfortunately, those who cannot perform it or do not understand the procedure help spread untruths about TUBA.  Such rumors and misconceptions create a disadvantage for the patient and an advantage for the surgeon who cannot offer their patients this technique.  Afterall, if you were a surgeon and your patient wished to have TUBA and you didn't perform it, would you recommend it and risk losing the patient?  And if you were that surgeon, would you go as far as recommending a surgeon in your patient's area who did, in fact, perform it?  Probably not. I had this procedure in 1998 and can vouch for the below content.

  1. TUBA is a dangerous procedure performed blindly by unqualified surgeons.
    This is absolutely false.  Endoscopic procedures are performed with a small camera so that the surgeon has an internal view of the patients body.  Although not every TUBA surgeon may be certified by the American Board of Plastic Surgery, many are.  The remainder are often cosmetic surgeons with hundreds of TUBA procedures logged.  A surgeon does not have to be certified by the American Board of Plastic Surgery to be a competent and talented surgeon.  Skill is what truly matters when choosing a surgeon, however if you require a board certified plastic surgeon trained in the art of TUBA instead of a cosmetic surgeon--they are easily found.
  2. Not only is it dangerous but you risk puncturing organs and massive bleeding which can not be controlled.
    This is not true.  The skin and fat are dissected away from the muscle fascia, the muscles of the abdomen are never cut or separated.  The pectoralis major muscles are dissected from the rib cage and pectoralis minor but the instruments do NOT go behind any ribs or abdominal muscles.  There are no sharp instruments used after the initial umbilicus incision therefore the chances of bleeding more than even 2 teaspoons is lessened considerably.  Only blunt dissection is used.
  3. You can only get implants placed above the muscle with TUBA.
    Yet another fallacy.  Breast implants can be placed under the muscle.  However some surgeons may prefer sub-glandular placement for other reasons so please discuss this with him or her.  I have several friends who have gotten TUBA unders and are thrilled with their results.  I CHOSE to have overs, I was not forced to settle for them because my surgeon didn't know how.
  4. The Breast Implant Manufacturer's warranties are voided in the event the TUBA procedure is utilized.
    False.  This is one of the top misconceptions regarding TUBA.  The implant is rolled up no more than with the trans-axillary (under arm) and areolar incisions.   The implant is never put under any stress or damaged in any way during implantation or during the filling process.  The warranty is not voided.
  5. Breasts often come out crooked, or asymmetrical, with the TUBA approach because it is more difficult to make the pocket.
    This is not true.  The skill of the surgeon plays a significant part in correctly determining the appropriate implant size and placing this implant in the proper fashion.  Asymmetry is just as common in traditional incision placements as TUBA.   As with any incision placement, the surgeon will raise the patient intra-operatively and view the position of the breasts in the upright position.  If any corrections must be made, they are carried out immediately.   It is also worth noting that asymmetry is almost always present pre-operatively in almost every patient.
  6. TUBA causes visible "tracks" from your navel to your breasts which may never fully go away.
    In the unlikely event that this would even happen now, it is more than likely a connective-tissue failure to adhere to the fascia of the abdomen muscles and not technique-specific.  This was first seen in the initial phases of the procedure  but is no longer an issue with the improved methods and instruments.  If in the event that you may notice tracks post-operatively, it is usually very temporary until the tissue adheres again from the dissection.  However, if this does remain after several months, and this is extremely rare, the tissue may be scored or rasped and the patient is instructed to wear a binder for several weeks.
  7. TUBA isn't even an"FDA approved procedure.
    Actually the breast implant manufacturers sought the FDA approval for recommendations of endoscopic methods such as the TUBA method and the trans-axillary method to be listed for their medical devices.  Unfortunately, the information was not submitted in time so both endoscopic methods could not legally be recommended by the implant manufacturers who were given approval (Inamed, formerly McGhan, and Mentor Corp) due to the red tape involved in product intention and labeling approval.   However, since implants themselves were only approved in May of 2000 it goes to show you that procedures, devices and other products are used without the magic words,  FDA approved.  The bottom line is that TUBA has been shown to be safe, if not safer, in realtime without the political hoopla.  Incidentally, both Mentor & McGhan (Inamed) submit a PMA (pre-market approval) application for various device labeling or specification changes every month to every few months regarding their breast implants which can ultimately result in a profit.
  8. Bottoming Out (where the natural breast crease lowers itself and becomes problematic) is an often seen complication of TUBA because of the dissection under the mammary fold.
    Not true.  The tunnels created are very small and do not cause bottoming out simply because of this method.  Bottoming out occurs in other incision methods, and statistically no more than any of these methods.
  9. Infections occur far more frequently with TUBA.
    The infection rate is the same, if not less, than standard incisions and are also determined by the individual surgeon's infection rate, whether or not the surgery is performed in a hospital and also depends upon the post-operative care of the patient.  The milk ducts are never cut nor is the implant ever passed through the areola where the incidence of Staphylococcus aureus (a common bacteria on the skin) is higher.
  10. You may never have taut abdominal skin or muscles again after TUBA.
    The skin of the abdomen is very elastic and very capable of extreme expansion.  Having said this, the expansion of the abdominal skin is very nominal intra-operatively and the abdominal muscles are never stretched or manipulated.  This surgery does not cause any long-term negative affects on the abdomen unless you specifically have poor elasticity or connective tissue problems.  If you don't have taut skin or muscles after healing completely from TUBA, you probably didn't have them immediately pre-operatively and only noticed it post-operatively due to the attention your abdomen receives after surgery.  Not to mention the abdominal muscles experience separation and the skin elasticity loss, with age.  If you notice puffiness or an untone appearance after breast augmentation surgery, including TUBA, please know the the swelling will seem to affect your abdomen more than other areas due to gravity and the edema collection around the breasts.  Not to mention if you have decided to stop working out or exercise as much post-surgery you will gain weight and lose tone.  After you have healed and are settled back into your normal exercise routine, you can then accurately determine any changes brought upon by the TUBA procedure. I personally noticed no problems after I healed.

When considering TUBA breast augmentation, ask your surgeon to view breast augmentation before and after pictures for previous TUBA patients. The surgeon can show you results from these patients and help to answer questions about any remaining concerns that you may have.



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(Updated on 02/23/10)
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