1. Trans-Abdominoplasty Silicone
Breast Augmentation
(TASBA)
Filiberto Rodriguez, MD, FACS, FAACS
RGV Cosmetic Surgery & Vein Care
McAllen, TX

2. No Financial Disclosures

3. Introduction
• Breast augmentation
remains hugely
popular
• Trans-Umbilical
Breast Augmentation
(TUBA) allows
minimally invasive
placement of saline
implants with no scars
on the breast

4. TUBA

5. TUBA
• Patient Selection
– Minimal breast ptosis
– Minimal assymetry
that can be corrected
with different sized
implants or fill volumes
– Ideally IMF not too
tight
• Know how to do

6. TUBA

7. TUBA - Cons
• Can only place Saline
implants
– Pt dissatisfaction with
feel of saline implants?
• Increased demand for
silicone gel implants
– Trans-axillary to avoid
breast scars in select
patients

8. Trans-Abdominoplasty
• Placement of silicone
implants via
abdominoplasty has
been described
• Not widely practiced
due to the limited
exposure from the
costal margin and the
challenging dissection

9. Keller Funnel 2
• Greatly facilitates
placement of silicone
gel implants through
smaller IM, PA, &
Trans-Ax incisions
• Theoretical
advantage for
decreased capsular
contracture

10. TASBA
1. TUBA pre-dissection
2. Abdominoplasty
3. Keller Funnel
4. Facilitated Trans-
Abdominoplasty
Silicone Breast
Augmentation
(TASBA)

11. 1. TUBA
• Patient selection as
per TUBA
• Use classic TUBA
techniques to dissect
subpectoral pocket
and place saline
sizers

12. 2. Elevate Abdominoplasty Flap
• Costal margin ~ 5-
6cm from IMF
• Dilate TUBA tracks 2
finger breadths
(similar to Trans-
Axillary)
• Allows use of blunt
finger dissection to
optimize pocket
(better than TUBA
alone)

13. 3. Keller Funnel 2
• Saline sizers are
removed
• Keller Funnel 2
facilitates placement
of silicone gel
implants into pre-
dissected supbectoral
pocket

14. TASBA Before & After at 6 weeks

15. TASBA Before & After at 8 weeks

16. Settling of the Implants
2 weeks post-op 8 weeks post-op

17. Pearls
• Wylie Renal Vein Retractor is very helpful
for exposure for placement of the Keller
Funnel and implant delivery
• Consider beginning Singulair
(Montelukast) 2 weeks prior and
continuing 3-4 months post-op to prevent
capsular contracture in this patient
population seeking to avoid scars on their
breasts

18. Summary
• In properly selected patients, the TASBA
procedure provides a wonderful alternative
for combined breast augmentation and
abdominoplasty (commonly referred to as
a Mommy Makeover) that avoids any
breast scars
• The combination of TUBA techniques with
the Keller Funnel greatly facilitates the
placement of silicone gel implants though
a trans-abdominoplasty approach

19. Thank you
South Padre Island, TX