Transumbilical endoscopic breast augmentation: submammary and subpectoral.

Endoscopic techniques have recently been applied to aesthetic cosmetic surgery procedures. Endoscopic bilateral augmentation mammaplasty through a transumbilical approach ("TUBA") has recently been advocated as an alternative technique. The purpose of this article is to describe the author's transumbilical technique, to identify procedural limitations and special considerations, and to retrospectively analyze preliminary results. Five hundred thirteen patients (n = 1026 breasts) who underwent submammary transumbilical augmentation from January of 1993 through December of 1998 were evaluated. In 1997, the technique was further developed to permit subpectoral placement of implants; an additional 140 patients (n = 280 breasts) who underwent subpectoral transumbilical augmentation from September of 1997 through February of 1999 will also be presented. Success of the technique was based upon a number of criteria, including completion of the operation without conversion to an inframammary incision or reoperation, normal nipple-areola sensation, absence of hematoma formation, absence of infection, no umbilical scar revision, and patient satisfaction. Complications included hematoma (n = 2 breasts), conversion to inframammary incision (n = 5 breasts), and required secondary corrective procedure (n = 3 breasts). The majority of these complications occurred early in the learning curve. The successful augmentation rate in 1306 breasts was 99.2 percent. Based upon these results, transumbilical endoscopic breast augmentation is believed to be a safe alternative technique with excellent results.