Disclaimer:
These videos are from Gabriel H. Patino, MD specialist in Cosmetic Surgery. The videos contain exclusively, Medical , Surgical, Scientific, Professional, Educational material. Medical Privacy Laws have been followed and all the videos have been done with the prior written consent and authorization from my patients.
Viewer discretion is advised because of nudity which may be considered sensitive content and may be offensive or disturbing to some people.
Procedure Description:
A breast augmentation is usually done under tumescent anesthesia and oral ( by mouth) sedation at the Cosmetic Surgical Center Of El Cerrito. Dr. Gabriel Patino recommends to have the breast implants inserted without any scars on the breasts, the nipples or the armpits. The Trans Umbilical Breast Augmentation (TUBA) or bellybutton approach consists of inserting the breast implants through a tiny incision inside the bellybutton which is the only natural scar in the human body. There are multiple advantages to the boob job via the navel. The most obvious one is the lack of wounds on the breasts, areolas (brown area surrounding the nipples)or axilas (armpits) . Capsular contracture is the most common complication after breast enlargement with implants. The risk of Capsular contracture with the trans axillary approach (via the armpits) is 6% which is the highest of all the different incisions. The nipple areolar complex ( NAC) approach ( incision around the nipples) has a 3% incidence of capsular contracture (internal scar which squeezes the implants and makes your breasts hard). The inframammary incisions ( wounds are on the fold under the breasts) has one of the lowest risk of capsular contracture at just 0.5%. The Transumbilical breast augmentation risk of capsular contracture is 0.2%. One of the theories is that capsular contracture is caused as a reaction of the body to a small amount of blood which remains around the breast implants. The Transumbilical incision is the only approach that allows for drainage of any remaining blood down through the two tunnels created from the breasts into the bellybutton. Drains are not needed because as you stand the fluid naturally drains down and exit via the Umbilical wound skin which does not have any internal sutures. The risk of bleeding is also much less because no cutting instruments (scalpel= knife, electrocautery = Electrical knife) are used to create the breast pockets ( cavities made to fit the implants). Instead, the sub muscular ( under the muscle) or sub glandular ( under the breast gland) pockets are created by hydro dissection ( water expansion) using the tumescent anesthesia ( Normal Saline = Salted water, lidocaine= numbing medicine, Epinephrine = Adrenaline) which is less traumatic. In addition the Adrenaline causes significant vasoconstriction (clamping of the blood vessels) which dramatically decreases the risk of bleeding. The risk of infection with the TUBA approach is also near zero perhaps because It is the only approach to the breasts that uses a single tiny incision instead of two larger incisions. Even if the bellybutton incision where to become infected, the risk of the infection reaching all the way to the breasts Is extremely unlikely. By contrast, any incisions on the Breasts ( periareolar or inframammary) are more likely to become infected because they are larger and perhaps because the breast implants can apply direct pressure over the wounds and cause a decrease in blood supply to the edge of the incisions which results in necrosis (death of the wound edge) and subsequent Infection.
