Transumbilical Breast Augmentation: The Procedure
After the incision is made within the belly button, Dr. Vitolo uses a tubular, baton-like device to tunnel in the subcutaneous tissue, not inside the abdomen, but just below the skin. This introducer is passed either beneath the breast tissue or beneath the pectoralis muscle underlying the breast. (The choice of position depends upon the individual patient, Dr. Vitolo and the patient's preference.)
The introducer is then removed and a suitably sized saline filled implant is selected. An eighteen-inch long filler tube is attached to the self-sealing valve in the implant; all the air is removed from the implant, which now becomes pancake like. The flattened implant is then rolled like a cigar and slipped up the tunnel that has been made by the introducer until it lies in the pocket underneath the breast. The filler tube extends out through the incision in the navel.
Using a special syringe device the implant is filled with sterile normal saline solution. As the implant is filled, it unrolls and creates a pocket for itself that is the exact size desired. The implant is over inflated and then deflated until the final desired volume is reached.
When the final shape and volume has been achieved, the filler tube is pulled upon and it slips out of the self-sealing valve. As the filler tube exits from the valve a diaphragm snaps closed and seals the implant. The filler tube is then completely removed and the implant remains filled underneath the breast. The identical procedure is then performed on the opposite side and a saline filled implant is inserted in a similar fashion. One can compensate for the variations in size and shapes of the two different breasts by using different volumes in the implants.
The incision in the belly button is closed with a dissolving suture and the patient is placed in a mildly compressive dressing for twenty-four hours.
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