Question: Is the rate of capsular contracture lower with transabdominal breast implant placement?

I'd like to have a tummy tuck and breast augmentation done at the same time. After having 6 kids, I have a large diastasis with an umbilical hernia and very deflated/small breasts. My biggest fear with going forward on this is having multiple incisions. I recently learned about transabdominal breast augmentation and wondered if this provided successful results. In general, what would hold me back from doing the breast augmentation is capsular contracture. What incision is best for preventing this? Is it true that the transabdominal and/or TUBA placement yields the lowest capsular contracture rate? I am totally fine with a saline implant and I actually prefer the look that these implants produce (higher placement, more projection, fuller look).

1 Comment

What a great question. 


Here's the thing:  If putting implants in through an abdominoplasty were in your best interest, I would do it every time. There's absolutely no downside to it. . .if it works. Unfortunately, it's one of those things in surgery that sounds better than it is.


Breast augmentation can be done essentially two ways. 1. Winging it. 2. Precise and controlled. The transabdominal approach is winging it. I can't see what I'm doing, it's done by feel. I can't tell if I accidentally make too much space in one area or another.  I can't tell if it's bleeding.  And I'm doing it from a LONG way away and making a cut in the most important border of the breast.  The surgery through and incision is precise and controlled. I can make millimeter by millimeter decisions. I can stop bleeding before it happens. I can make minor adjustments if the sizer isn't exactly how I want it and so on.

  

I wish I could tell you the TUBA is the way to go but I've been through this enough times with people to know that the incision is a nuisance but tolerable for almost everyone. Implants that don't look great because I was winging it would never be tolerable to me and probably wouldn't be tolerable to you. You'll be mad at your surgeon. Your surgeon will be mad at your surgeon.  So I'd advise against it. 


Best,

Dr. Jeremy Pyle

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