The tunnel can be placed either beneath the breast tissue or beneath the muscle, depending on the placement desired. To verify the position of the tunnel, a long laparoscope (which is a long television camera) is inserted into each tunnel. The position of the tunnel is clearly visible on a digital monitor as is the entire length of the tunnel. The laparoscope is removed and a saline implant sizer is rolled up like a cigar and inserted into the tunnel and pushed up until it is in a position where we want the implant to go. The sizers are then inflated through their long fill tubes that extend out of the navel, with sterile saline solution (ie: sterile salt water which is a normal body fluid that is also used in IV lines into the body).
The asleep patient is placed in a sitting position on the operating table, and the sizers are slowly inflated until the breasts are the size desired (based on a picture that the patient has selected as the desired size). Since most women’s breasts are rarely the same size, the sizers are usually inflated differently. During the inflation procedure the implants are slowly filled, creating their own pocket, gently pushing the tissue beneath the breast tissue out of the way. There is no cutting of tissue or burning of tissue with electrocautery, as is the usual dissection technique with the other surgical approaches.
This implant pocket creation technique causes almost no bleeding because the pocket is not made by cutting the tissues, but by gently pushing the tissues out of the way. Because there is minimal trauma to the tissues, as is caused in the other techniques, healing is very short after the procedure, with almost no bleeding, allowing the average patient to return to work in 1 to 2 days.
With the patient still sitting, the volumes of the saline in the sizer are adjusted until the breasts look as close to the sizing picture as possible. Then the saline is removed from each implant and recorded. We now know exactly what size implant to use and how much to fill each one. The sizers are removed and the patient is placed in a flat position. Based on the volume measurements we then select the appropriate implants. The real implants have a very secure self sealing valve in which we place a removable long fill tube. Each implant is rolled up like a cigar, slid up the tunnel, and inflated with the correct amount of sterile saline, directly from an IV bag through a sterile tubing in a completely closed system. When both implants are filled, we sit the patient up in a sitting position, and we make final adjustments to fine tune the implant volumes. When we are convinced the breasts are as close to the sizing picture and as symmetrical as possible, we remove the fill tubes. As the fill tubes pass through the self sealing valves, the valves snap shut. The patient is placed flat and the tiny incision in the navel is closed with a few self dissolving sutures. The patient is placed in a breast dressing, and awakened from anesthesia if used.
This complete procedure, from incision to closure typically takes less than 30 minutes, and patients usually go home from the recovery area an hour or so after surgery. Most patients can return to work within 1 to 2 days.
Dr. Vitolo’s unique approach to Transumbilical Breast Augmentation is reflective of his dedication and passion for innovative plastic surgery that focuses on the patient’s health and happiness. Dr. Vitolo’s goal is to have the patient so wildly happy with the results that they only have the surgery done once.