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Transumbilical Breast Augmentation: A Practical Review of a Growing Technique

Brennan, William A. MD; Haiavy, Jacob MD

doi: 10.1097/SAP.0b013e318030264f
Original Article

Background: The transumbilical breast augmentation procedure has been described in the literature since 1993. This indirect route for implant placement has received both criticism and praise over the years, without a comprehensive assessment of the procedure from the perspective of the patient. The growing patient demand for the procedure, combined with the increased use by surgeons, prompts a review of the procedure and a discussion of its pros and cons, including tabulated patient satisfaction data.

Methods: A retrospective chart review of 245 transumbilical breast augmentations performed by the second author from 2002 to 2004, including the 1-year patient satisfaction surveys, is presented. Additionally, complications from the procedure are also tabulated and compared with the complications published by our studies' dominant implant manufacturer in their 1-year follow-up published data. The patients were asked to rate their postoperative pain, numbness, firmness, size satisfaction, rippling, and overall satisfaction. Data were compiled and statistical analysis was performed using χ2 methods.

Results: The study revealed a strong negative correlation between both the study parameters of prepectoral implant location and postoperative firmness and the survey result of overall satisfaction (P = 0.0041). Conversely, numbness, pain, and rippling, long felt to be linked to satisfaction, were shown to have no statistical correlation with satisfaction. A strong positive correlation with satisfaction was seen with retropectoral (submuscular) implant location. The complications from transumbilical breast augmentation in our study were hematoma = 1 (0.4%), umbilical wound infection = 8 (3.2%), deflation = 3 (1.2%), tunnel seromas = 5 (2.0%), asymmetry = 10 (4.1%), capsular contracture = 9 (3.7%), implant infection (0.0%). These complication rates were comparable or less than other published methods of breast prosthesis implantation.

Conclusions: Transumbilical breast augmentation is a safe and effective method for breast implant placement in selected patients. Patient satisfaction weighs heavily on implant location and postoperative firmness and less on other variables. The procedure is associated with a complication rate comparable with other methods and finds itself growing in demand and popularity secondary to high patient satisfaction.

A review of 245 transumbilical breast augmentations demonstrated complication rates comparable to other routes of implantation. Higher patient satisfaction scores were seen with subpectoral placement.

From *Surgical Arts of Beverly Hills, Inc., Beverly Hills, California, and †Inland Cosmetic Surgery, Rancho Cucamonga, California.

Received September 13, 2006, and accepted for publication, after revision, November 28, 2006.

The preliminary data from this study have been presented at the American Academy of Cosmetic Surgery Annual Meeting, Orlando, Florida, January 2006.

Financial Disclosure and Products: Neither William A. Brennan, MD, nor Jacob Haiavy, MD, has any financial interest in the manufacturers or products mentioned in this manuscript. This manuscript was prepared without outside support from any corporate sponsor or affiliation.

Reprints: William A. Brennan, MD, Surgical Arts of Beverly Hills, Inc., 9401 Wilshire Blvd., Suite 1105, Beverly Hills, CA 90212. E-mail:

© 2007 Lippincott Williams & Wilkins, Inc.