What it is Like to Have No-Scar Breast Implant Surgery, Part 2

When we left off, you were in the middle of your transumbilical breast augmentation surgery. You had been sedated, had an incision made in your navel, and an instrument had tunneled up to each breast. This allowed for the balloon-expander to create the space for your new implants. When this is removed, the space is then checked for bleeding. Remember that the pressure of the balloon expander has probably stopped any bleeding so far. Then the new pocket is irrigated with a sterile saline solution containing an antibiotic. Antibiotic solution sterilizes the implant pocket to prevent infections. Dr. Yoho is batting 1000 on this record—he can gratefully say that he has not seen a single infection from this procedure. In addition to dangerous infections, minor infections are thought to contribute to the danger of a complication called capsular contracture, or hardening of the breast around the implant. So the antibiotic solution might help to prevent this complication as well.

Next, Dr. Yoho puts a long-acting local anesthetic right inside the implant pocket. Having a local inside the breast has a painkiller effect in the area for up to 8 hours after surgery. This is important so that the patient has plenty of time to take her pain pill after waking up. This keeps the post-op pain to a bare minimum.

Now, it is time to place the actual implants. The tiny incision does not allow for a filled implant to be pushed through the belly button. So the empty implant is placed through the small tunnels under the skin while it is rolled up (like a taquito, as Dr. Yoho describes it). These are threaded up to the breasts using a “no-touch” technique. This technique doesn’t mean that Dr. Yoho operates with a “Look ma, no hands!” kind of recklessness. It means that, although he does use hands, the implant and the patient are both wetted down with the antibiotic saline solution so that all surfaces are sanitized as the surgeon is working. After the implants are in place, they are then filled with sterile saline.

Once the implants are placed and filled, Dr. Yoho sits the patient up. This is to check the evenness of the breasts and the appearance (because we don’t look the same sitting or standing as we do lying down). Although, just like natural breasts, implants are rarely if ever perfectly even, Dr. Yoho checks and adjusts the saline levels to make sure they are as symmetrical as possible. Once the desired levels are reached, Dr. Yoho tugs out the fill tubes. The implants have a valve that self-seals once these tubes come out.

After the tubes come out, your surgery is basically finished. Your breasts will immediately be wrapped with a light elastic bandage to help prevent swelling. A sports bra is placed over this, and an elastic band is placed above the breasts. You will also have a small dressing covering the little belly button incision.

By the time this is completed, you will be awake. Your family or friends can then come in and see you in recovery.

Part 3 will cover the surgical recovery.

What Is it Like to Have No-Scar Breast Implant Surgery: Part 1

Do you know what TUBA is? No, not the musical instrument. It’s actually a kind of cosmetic surgery. TUBA stands for Trans-Umbilical Breast Augmentation. This surgery actually puts in the breast implants through an incision in the belly button (also called the umbilicus). This way, there is no scar in and around the breast after the breast augmentation surgery. This surgery is favored by Dr. Yoho for its safety, speed, accuracy, and for the no-scar results. Well, to be specific, there is a scar, but it’s inside the belly button-not an area that most patients worry about. Dr. Yoho has successfully performed TUBA method surgery thousands of times.

Transumbilical breast augmentation has many advantages over standard approaches for the right patient. Patients experience less downtime and need less post-operative care. So who is the right patient? Good candidates desire larger breast or need breast reconstruction. Good candidates for TUBA also do not want or need a breast lift in addition to breast augmentation, and have good skin elasticity (relatively tight skin). Finally, as with other surgeries, candidates should be in good physical and mental condition (no active diseases, disorders, or mental instabilities).

So, how can breast implants be placed through the navel?

If you were to have TUBA surgery, you would probably be on the operating table for less than an hour. In fact, typical transumbilical breast augmentation takes as little as 20 to 30 minutes. You could have either general anesthetic (which knocks you out), or local anesthesia with IV sedation. Dr. Yoho has long used this special light sedation method to reduce patient side effects from anesthesia. Although the patient is awake during surgery, they are given relaxation medicine and usually don’t remember anything.

But we’re getting ahead of ourselves. The first step would be a consultation to evaluate you as a candidate. Then you would decide on the size of your implants. You will try on some different outfits with bra implants to see how you feel with different sizes. Dr. Yoho will also help you to evaluate sizes in terms of your body frame and current breast shape and size. When you go in on the day of surgery, you will once again talk to Dr. Yoho about the implant sizing, and he will mark your body in preparation for the surgery. The lines that cosmetic surgeons draw on patients’ bodies are like a diagram for the operation, partly because bodies look different lying down than standing up. In the case of TUBA, the lines show where the tunnels will go from your belly button to your breasts. You will then be taken to the operating room.

You will be sedated and prepped for surgery. You will receive local anesthetic around the breasts and around your belly button area that will help reduce soreness in post-op and reduce bleeding during surgery. Then, the actual incision is made in your navel. Dr. Yoho carefully separates the tissues around the navel, which helps to prevent the formation of scar tissue. Dr. Yoho thinks that this is one of the advantages of his extensive experience: doctors with less experience might not do this.

Next, a device is threaded inside the incision that creates a tunnel between the navel and each breast. These tunnels are done with a blunt device and not with a knife. In other words, there is no cutting or slicing of tissue in the tunneling procedure. Pockets are also created in the breast area to hold the implant. Dr. Yoho will consult with you before the procedure about his placement (under or over the muscle) of your breast implants.

Next, a tube is run up to the breast with a balloon-expander device. This is inflated until the tissue is taught so that the pressure slows or stops the bleeding, and also finishes the space inside so that the implant will rest easily and naturally after surgery.

Next week: part 2.

Cosmetic Surgery 2.0

On the Internet, there is a saying that the new Internet is version 2.0. We like to think that our cosmetic surgery is version 2.0. Shorter recovery times, simpler procedures, more natural results, and overall safety improvements are what we strive for and what the latest technology promises. We are doing our best every year to bring you a superior experience and better results with the latest techniques in surgery and recovery. See DrYoho.com or look at the affiliated websites to which Dr. Yoho contributes numerous blog posts, which can be found by googling “Dr. Yoho.”

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Robert Yoho, M.D.

Did You Know That All of Our Surgeries Can Be Done Awake?

If you have special fears of anesthetic, we can perform your surgery under local anesthesia, even a tummy tuck. We do give some oral medicines and perhaps a shot prior to the main event, to be sure that you’re nice and relaxed and not afraid. However, the local anesthetic does the trick for the pain relief, and you can watch the whole thing.

We have successfully performed breast augmentations, liposuctions, tummy tucks, facelifts, and eyelid procedures all under pure local anesthetic technique. If fear of general anesthetic is your issue, please be sure to ask us about this possibility.

While we’re able to do the above, we generally feel that a little intravenous sedation is appropriate for most patients and they usually do respond very well without any nausea or other discomfort. We can keep you comfortable and unaware of your surroundings without using all the drugs and so on that make general anesthetic such an uncomfortable and possibly hazardous experience. Ask us about our anesthetic techniques when you come in for your consultation.

Liposuction Revolution!

Sushi dinner in Hawaii

Did you know that finally there is a new machine that helps liposuction surgery? We have tried almost every single new device (laser, Vaser, “Smart” Lipo, etc. etc) over the years, and they have provided minimal improvements at best. They just weren’t worth buying because they didn’t work. Since our experience extends over almost 20 years and 10,000 cases we knew they didn’t work.

Now, we have the new Power X® liposuction machine. It is a refinement of a patented design that has been around for almost a decade. The old machine broke down, and worked just a little, but the new one has been completely re-engineered by a new company and we bought one the first day we tried it. I do not spend money on devices that don’t work. Every fool and his mother is trying to sell me something because they believe we are a gold mine and foolish enough to buy any type of medical device.

This thing safely speeds the procedure up. We think we are spending 1/3 less time on liposuction; in other words, you need half the medication you would have used with the manual systems. Anesthesia medications are the most dangerous thing in the operating room, as they have the potential to cause you not only discomfort post operatively, but problems during surgery, sometimes serious ones. We have to watch carefully during the procedure to be sure you don’t get too much medication.

An additional benefit: we think it helps prevent some of the irregularities in skin quality that inevitably occur after some liposuction procedures. AND we have seen no more complications or problems post operatively than we had before.

Don’t be fooled: our experience still means a lot. Surgeons can’t start out and get great results because they have this machine. We still need all our expertise. But we think this device will improve our results, your postoperative experience, and our overall safety.

Call our office today to see how you can benefit from the LIPOSUCTION REVOLUTION!

Patient Describes Liposuction, Blepharoplasty, Cheek Implants, and Tummy Tuck

Patient: About 25 or 26 years ago, I had a tummy tuck by another surgeon: it was the one where they cut you and has the scar. I was unhappy with it. I did not like the scar. The scar went from hip to hip plus I developed keloids too from it. I went all these years unhappy and then about 12 years ago, liposuction. became popular and I decided to come see you, Dr. Yoho about it and the first thing you did, which I loved was you put me in a room and I watched the video. I watched the video with the old-fashioned tummy tuck and with the liposuction With the liposuction, there were no scars just a little needle marks and that was it. As soon I saw that, I said this is it and I noticed the difference in the body, which I felt that with the other surgery I am looking more like a square where this surgery it was contoured toward the body more. So I signed up immediately to have you do it for me and the reason I took me so long was because like I said I thought this was for rich people only and I was surprised that the prices and everything else. I had it done on a Wednesday and by Friday I was out with my girlfriend shopping for some new tops because my other tops were too big already. It was amazing. It totally amazed me. Then my girlfriend named ---------, she was so amazed with it that she was probably the largest case you did as I recall it that time and she had the same thing done. We were just flabbergasted with it. Then I came back later and I had these lumps where when I put my bra on I had these lumps behind my bra straps that bothered me. I came and you got rid of those for me so when I put on a dress it was nice and flat, I did not have all these little lumps. Then you did my cheekbones. I did not have this all at ones. This is like 3 to 5 years later. Because my face, I was tired or people asking me if I was tired and I would say no I am not tired. My face was flat. There was no shape to it. So of course, you did my cheekbones and I am crazy about it. I think you did one more thing for me. I think it was around … I know you did 1 more thing. I hope it was my eyes or … Oh yes you did. I think you did the bags under my eyes also. It just makes me feel better. The older I get, I feel better. I have a very loving husband. He loves me the way I am, but it makes me feel good and makes me happy. If it makes me happy, it makes them happy.I trust you. I love the work you do. You have done my daughter’s breasts, you did a friend of ours, ---------- breast, you did my friend, ------------- and she was the largest case you ever did, I remember that. If you ever look up your chart, her name is ---------- and I think you even used it at one of your lectures.

Dr. Yoho has patients come from all over Southern California to have their appearance improved with our special surgical technique. Our Cosmetic Surgery center in Pasadena, California specializes primarily in Los Angeles Cosmetic Surgery including breast augmentation Los Angeles, liposuction Los Angeles, tummy tucks Los Angeles, cosmetic facelift Los Angeles, forehead lift, Chin and jowl liposuction, Eyelid Surgery Los Angeles and other body contouring procedures. The center is lead by expert Los Angeles Cosmetic Surgeon Dr. Yoho, who has passed the Boards in Cosmetic Surgery and is dedicated to providing high quality yet affordable cosmetic surgery options for his patients and being the best cosmetic surgeon in Los Angeles, Glendale, Pasadena, and Beverly Hills.