Breast Augmentation through the Belly Button

The transumbilical approach to breast augmentation has advocates, but the vast majority of plastic surgeons prefer other surgical approaches. Surgeons, who prefer the transumbilical approach, feel that this procedure has a major advantage - less scarring. They believe that transumbilical incisions heal imperceptibly. They acknowledge that there’s a steep learning curve with this procedure and that there are potential problems with implant malposition. There’s no question that excellent results can be obtained with this procedure.

The majority of plastic surgeons prefer the transaxillary infra-mammary or peri areolar incisions. They feel that these incisions are associated with a decreased incidence of implant malposition. They also feel that scarring with these incisions is rarely a problem. 

They feel that the probability of implant malposition with transumbilical incisions is higher than the probability of adverse scarring with traditional breast augmentation incisions. 

It’s important to realize that surgeons have different comfort levels with different incisions.  They do their best work when they are able to use their preferred incision. Although good results can be obtained with transumbilical incisions there’s probably a good reason why the majority of plastic surgeons prefer traditional surgical approaches.   

Brachioplasty and Scarring

It’s not unusual for massive weight loss patients to develop redundant upper arm tissue. When this occurs it can represent a significant aesthetic deformity that can adversely impact self-esteem and self- image. When sag of this magnitude is present, the majority of patients require a full brachioplasty.

This procedure involves making an incision that extends from the axilla to the elbow. This approach removes excess skin in the vertical and transverse dimensions. Unfortunately, it’s virtually impossible to hide scars in this location. For this reason, brachioplasty patients are often dependent upon their wound healing characteristics for a good result. In other words, when wounds heal nicely, scars can be imperceptible; conversely, some patients will  have notable scars

                

The vast majority of patients tend to heal these incisions nicely, and the aesthetic results are excellent. Unfortunately, some patients form exuberant scar tissue, which can be very noticeable. When this situation occurs, these scars represent a significant aesthetic deformity which is difficult to hide. Under these circumstances, scar revision and long sleeve shirts may be the only options available for patients.

              

In the post-operative period, various maneuvers can minimize scarring. These include massage, topical creams, and silastic. If you’re considering this procedure it’s important to understand the potential for scarring and its irreversible nature. The majority of patients have excellent results, but occasionally patients are unhappy with scarring and request scar revision. 

Scar Treatment following Cosmetic Surgery

A large variety of agents are currently available for the treatment of scarring.  At this point in time, there doesn't seem to be a consensus amongst plastic surgeons regarding their effectiveness. Nevertheless, their use appears to be increasing amongst cosmetic surgery patients.

These agents include a variety of topical agents and silastic sheeting. We generally recommend starting them 2 to 3 weeks following surgery as long as no open areas or scabbing is present.

It’ s important to discuss scar treatment with your plastic surgeon. Your surgeon should be able to make an appropriate recommendation.