Transumbilical Retroglandular Breast Augmentation, a Review of 158 Cases and a Comparison with Traditional Approaches

Abstract

Introduction: The transumbilical (TU) approach for breast augmentation is performed with endoscopical assistance and leaves no visible scar on the breast. The recovery time should be shortened and the complication rate should be decreased compared with those of the standard periareolar (PA) or of the inframammary (IM) approach. This study was undertaken to compare the results of these three surgical procedures. Materials and Methods: This retrospective study of 214 patients evaluated 158 patients with the TU approach, 27 patients with the PA approach, and 29 patients with the IM approach. Group I patients are those who had surgery in the first 9 months and Group II patients are those who had surgery in the second 9 months. Statistical data were tabulated for surgery and anesthesia time, blood loss, implant size, patient age, and follow-up time. Complications were reported and compared for the different surgeries. Results: There was no significant difference in the age of the patients in these three groups. Surgery time was longest for the PA approach and was not significantly different between the TU and IM approaches. The implant sizes were comparable between the three groups. Less hematoma formation, fewer infections, less sensory dysfunction and postoperative pain and swelling were seen in the TU patients. Also, the complications in the Group II-TU patients was less when compared with patients in Group I-TU. Some problems, like healing of the umbilical incision, disconnection of the filling tube, and irritation of the abdominal tissues, are specific to the TU approach. Discussion: The results of this study showed a similar or smaller number of problems with the TU approach if the patient selection is correct. With increasing operator experience, a significant decrease in complications was seen. The TU approach is a good alternative and a valid procedure for the right patient.