Good morning everyone! This is Dr. George Boris, and today we’re going to start by doing a transumbilical breast augmentation and a tummy tuck on this patient.
We’re going to begin by doing the transumbilical breast augmentation, the belly button has been used. This lady, when she stands up, has very droopy breasts, and I think many doctors would suggest to have a breast lift, which is a four-hour surgery with cuts all around the breast.
About the Procedure
We’re going to do transumbilical breast augmentation, and I think with a high-profile implant and high volume, she’s going to get a beautiful lift without any cuts on the breast at all, which is really good.
Then after we do that, we’re going to go and take out a big apron of skin and fat just hanging here, which is what we just wanted to take out. We marked where we’re going to be cutting out the skin.
We’re gonna isolate the belly button here, and then once all this skin is out, we’re gonna bring this in down to the pubic area, bring up the pubic area at the same time, and also we’re going to tighten the muscles, and then we’re going to close it without this apron of fat. So we’re gonna begin.
The Transumbilical Breast Augmentation
We’re starting with transumbilical breast augmentation, and I’m making my incision inside the belly button. Now I’m going to have access to do my augmentation. I’m going to continue the incision all around, preserving the belly button, and then a tummy tuck.
Preparation for the Implants
But to begin with, I’m going to do the through this incision I just made, we’re going to do the augmentation. So the first thing we’re going to do now is make tunnels to get to the breast, and so we’re gonna do that now. So here, under the skin, parallel to the skin, you could see me sneaking down the skin to the breast.
I am just sneaking up at the breast, and then I’m gonna lift up the muscle and a breast and go under both the muscles and the breast. You can see me here where I’m tipping up the physical pectoralis muscle. I’m under the breast, under the pectoralis muscle, tinting it up. I have done that on the left side, and now I am gonna do that on the right side.
You can see me simply tipping it under the skin, under the muscle here, and under the breast. So I’m under the breasts, under the muscle I created a tunnel, and now I’m going to sweep, go through the tunnel and sweep down, lifting the muscle – the pectoralis muscle and the breast of the ribcage creating my placement for the pocket for the implant on the base of the breast. So elevating the muscle of the ribcage so that’s where the pockets are going to be on the right side. Now the left side, the same thing – under the breast, under the muscle, swept down.
Placing the Implants
I created my pocket, lifting the ribcage, the breast, and the muscle. Now we place the implants in. Here is my implant rolled up like a cigar, deflated to let all the air out of it, and put it into this instrument that I am gonna be using to go through the tunnel up to the breast area. She chose to go to 650 CCs, and the implant is now placed in the pocket I’ve created under the breast, under the muscle, and we’re going to inflate it now.
We do it, we get the fluid from the IV, and it goes through tubing into a syringe, and once the syringe is pushed out its redirected with this special valve into the tubing, into the breast implant. Her inframammary fold was very shallow, close to the areola and abdomen, so this area here will become falter. So implants are filled in with 650 CCs so now we will take tubing out of the implant and the implant self-seals.
The Advantages of Transumbilical Approach
So it’s a new technology doing through the belly button the breast implants in my experience, I get beautiful placement, much less complication during the transumbilical. However, we do it through the areola too, and with the skin below as well. But just that this way is really good, it’s really nice.
I am pulling the tubing out of the implant now, and the implant self-seals. These implants do not have to be changed, unlike silicone implants. When she’s hundred years old, she looks hot. Nothing will changed.
The Tummy Tuck
So now we’re gonna do the tummy tuck. I just started the tummy tuck and what I’m going to do is isolate the belly button with a circumferential incision so that keep that intact. Observe the belly button right here. And I’ve raised up the skin, and now we are going to tighten the muscles. It’s interesting, the muscles here and the muscle here, we have inches of separation and we are gonna tighten that.
English 
English 
Spanish