TASBA Talk
- 1. Trans-Abdominoplasty Silicone Breast Augmentation (TASBA) Filiberto Rodriguez, MD, FACS, FAACS RGV Cosmetic Surgery & Vein Care McAllen, TX
- 3. Introduction • Breast augmentation remains hugely popular • Trans-Umbilical Breast Augmentation (TUBA) allows minimally invasive placement of saline implants with no scars on the breast
- 4. TUBA
- 5. TUBA • Patient Selection – Minimal breast ptosis – Minimal assymetry that can be corrected with different sized implants or fill volumes – Ideally IMF not too tight • Know how to do
- 6. TUBA
- 7. TUBA - Cons • Can only place Saline implants – Pt dissatisfaction with feel of saline implants? • Increased demand for silicone gel implants – Trans-axillary to avoid breast scars in select patients
- 8. Trans-Abdominoplasty • Placement of silicone implants via abdominoplasty has been described • Not widely practiced due to the limited exposure from the costal margin and the challenging dissection
- 9. Keller Funnel 2 • Greatly facilitates placement of silicone gel implants through smaller IM, PA, & Trans-Ax incisions • Theoretical advantage for decreased capsular contracture
- 10. TASBA 1. TUBA pre-dissection 2. Abdominoplasty 3. Keller Funnel 4. Facilitated Trans- Abdominoplasty Silicone Breast Augmentation (TASBA)
- 11. 1. TUBA • Patient selection as per TUBA • Use classic TUBA techniques to dissect subpectoral pocket and place saline sizers
- 12. 2. Elevate Abdominoplasty Flap • Costal margin ~ 5- 6cm from IMF • Dilate TUBA tracks 2 finger breadths (similar to Trans- Axillary) • Allows use of blunt finger dissection to optimize pocket (better than TUBA alone)
- 13. 3. Keller Funnel 2 • Saline sizers are removed • Keller Funnel 2 facilitates placement of silicone gel implants into pre- dissected supbectoral pocket
- 14. TASBA Before & After at 6 weeks
- 15. TASBA Before & After at 8 weeks
- 16. Settling of the Implants 2 weeks post-op 8 weeks post-op
- 17. Pearls • Wylie Renal Vein Retractor is very helpful for exposure for placement of the Keller Funnel and implant delivery • Consider beginning Singulair (Montelukast) 2 weeks prior and continuing 3-4 months post-op to prevent capsular contracture in this patient population seeking to avoid scars on their breasts
- 18. Summary • In properly selected patients, the TASBA procedure provides a wonderful alternative for combined breast augmentation and abdominoplasty (commonly referred to as a Mommy Makeover) that avoids any breast scars • The combination of TUBA techniques with the Keller Funnel greatly facilitates the placement of silicone gel implants though a trans-abdominoplasty approach
- 19. Thank you South Padre Island, TX