Transumbilical Breast Augmentation (TUBA)

Choosing to have a TUBA Procedure

The only approach to breast augmentation that leaves no scar on the breast is transumbilical breast augmentation (TUBA), which utilizes an incision hidden in the belly button, or umbilicus (hence, “transumbilical”). This is a procedure that is more technically difficult than conventional approaches to breast augmentation and therefore is not performed by most plastic surgeons. Dr. Goldman is one of the only surgeons in Ohio who performs TUBA frequently. When utilized with precision, this technique can yield results indistinguishable from conventional breast augmentation.

How is a TUBA procedure performed?

Cleveland Ohio Transumbilical breast augmentation is a “blind” technique. The surgeon creates a pocket for the implant under the chest muscle (the pectoralis major) by feel, using instruments created for this purpose. An endoscope (a surgical telescope) is used by some surgeons, including Dr. Goldman, to check the pocket and verify subpectoral (under the muscle) placement. Historically, TUBA was used to perform subglandular (over the pectoralis major muscle, directly under the breast tissue or gland) breast augmentation. Most patients will get a better cosmetic result with subpectoral breast augmentation. Recent technical developments have allowed the latter. The surgeon tunnels under the skin from the belly button to the breast and then elevates a pocket under the muscle by feel, using the tactile sense of his or her hands and the visual appearance of the breast contours to guide the dissection.

Only saline-filled breast implants can be used with a Cleveland Ohio TUBA, because the implants are gently pushed through the tunnels from the belly button to the breasts while uninflated; they are inflated with saline (salt water) through a fill-tube once they are in the proper location. Silicone implants come pre-filled and sealed from the manufacturer and are therefore too large to pass through the subcutaneous tunnels and into the breast pockets.

Studies of this procedure have shown no increase in breast implant complication rates, such as infection, bleeding, capsular contracture (excess scar tissue around the breast implants).

What is the difference with this and other techniques?

Dr. Goldman believes that there is an increased chance of having asymmetry between the right and left breasts because the TUBA is a blind technique performed through a distant incision in the belly button. Postoperatively, there tends to be mild bruising; bruising is infrequent when Dr. Goldman performs breast augmentation through an incision in the fold underneath the breast (inframammary fold). The breast implants also tend to sit higher on the chest after a TUBA procedure than conventional techniques. The implants generally settle nicely into place within 3 to 6 weeks after the procedure; with subtle settling occurring over about 3 months postoperatively, which is similar to traditional techniques.

Why Choose Dr. Goldman?

Dr. Goldman is not only board certified in plastic surgery, he also has extensive experience in cosmetic breast surgery and breast cancer reconstruction. Since TUBA is a relatively new technique, and not performed by most plastic surgeons, it is essential to find a surgeon who understands and is familiar with Transumbilical breast augmentation and related techniques.

To contact us for more information call our office at 216.514.8899 or email us at