For those patients who are considering a Mommy Makeover that includes a breast augmentation and a tummy tuck, there is a surgical option that leaves absolutely no scar on the breast. It’s called the Transabdominal Breast Augmentation, or TABA. Dr. Richard Zienowicz of Providence, RI is somewhat of an expert on this technique as he’s one of only a handful of surgeons in the country who perform it. TABA works by allowing the surgeon to use your tummy tuck incision to place your implant. Brilliant, right?
by Katherine Stuart
and Richard Zienowicz, MD
TABA Has the Lowest Rate of Capsular Contracture
Traditionally, if a woman wanted a breast augmentation, she had three options for her incision: under the breast, through the nipple, or through the armpit. All of these methods will leave some degree of scarring. But with the TABA method, there is no breast scar at all since the implant is put in position through the tummy tuck incision. Furthermore, the TABA method has the lowest rate of capsular contracture — less than 1% according to Dr. Zienowicz, because the surgeon never actually touches the skin of the breast. It is effective with both saline and silicone implants, placed either above or below the muscle.
The other advantage to the TABA method for Zienowicz is that it gives the surgeon, “total control over the lower part of the breast”. Since the tummy tuck incision is so large, hip bone to hip bone for most patients, it gives him a better view of the surgical area and room to work. This allows him to take patients with ptosis or sagging breasts and rejuvenate their breasts with an implant alone. “It’s the perfect procedure (for grade B ptosis),” says Zienowicz. “In virtually every case, you have complete control of that lower pole and you can expand it from underneath because you have nice, direct access to that whole inframammary fold area.” Even in patients with grade C ptosis, where the nipple hangs below the fold, Dr. Zienowicz can reestablish the crease under the breast assuming that they don’t need a breast lift.
TABA Can Only Be Performed with a Tummy Tuck
The obvious “downside” to the TABA procedure is that it can only be performed in conjunction with a tummy tuck, which isn’t a downside at all if you are also seeking a Mommy Makeover. “It is truly the ultimate Mommy Makeover because it rejuvenates the two principal areas of aging in moms, which are the lower tummy and the breasts, and it gives you the most perfect access to the breast implant that you could have,” says Zienowicz.
Although it’s been around for quite a while, many surgeons have been reluctant to embrace the TABA method since the inframammary fold has historically been sacrosanct. This is slowly changing. Dr. Zienowicz, “designed a procedure that was published in 2009 called AMBRA, Augmentation Mammoplasty By Reverse Abdominoplasty, where (he) showed that you can totally reposition the inframammary fold surgically.” He and his colleagues then got together in San Diego for an ASAPS panel where they agreed that they all actually violate or change the inframammary fold with every breast augmentation. Since then, the TABA method has gradually been gaining popularity. And we understand why. No scars. Low CC rate. Sign us up.