Hidden Incision
(Transaxillary or Transumbilical) Breast Augmentation
Breast Augmentation is one of the most rewarding cosmetic procedures for both the patient and cosmetic surgeon. Implants can be placed to augment the contour of one’s native breast tissue and for enhancing the shape and volume of the female breast. Today’s modern techniques includes weekend recovery and back to office work the following week is even possible in most cases.
Choices involved during the decision making process of breast augmentation consists of 1. type of implant 2. location of implant, and 3. where to place access incision. Each of these choices have certain advantages depending on goals one wishes to achieve.
Either saline or silicone implants can be used. FDA has approved both the Allergan and Mentor types of implants.When placing silicone breast implants, we use the game changing Keller Funnel “No Touch” technique to minimize incision length, promote less postoperative discomfort, and decrease risk of capsular contracture.
The location of the implant placement can be directly under the breast gland, under the pectoralis major muscle, or under the pectoralis muscular fascia. If at all possible, we prefer to have as much of the patient’s native tissue including fascia or muscle covering the prosthesis for a more natural appearance.
Since most of our patients, if able, prefer not to have an incision on their breast, they often lean toward the hidden incision in the transaxillary (armpit) or transumbilical (belly button) approaches. Access incisions can be either local to the breast or remote. Local incisions are made directly on the breast. While placing an incision on the breast tissue, these allow for direct access to the breast anatomy. Local incisions can be periareolar (around the darker central portion of the breast) or inframammary fold (underside of the breast near the breast fold.) Remote incisions certainly have the advantage of not putting an incision on the breast. However, not all cases/body builds can be done from remote location. Hidden remote incisions can be either transaxillary (hidden in the hair bearing skin of armpit or axilla) or transumbilical (hidden in natural scar of umbilicus or belly button.) The axillary or umbilical approaches can be very useful to the right patient.
Dr. Hah is the only cosmetic plastic surgeon in Southeast Texas who routinely uses all 4 approaches of breast augmentation: direct approaches of making incision on the breast (periareolar and inframammary) and remote access hidden incisions of transaxillary (armpit crease) and transumbilical (belly button) . Our practice is honored that Wilbur Hah, MD was recently listed for the second successful year in America’s Top Plastic Surgeons. Dr. Hah has Triple Board Certification in Cosmetic Plastic Surgery. He was honored to serve as the 2014-2015 president of the American Society of Cosmetic Breast Surgery. Several times a year, Dr. Hah is also an invited instructor at live surgery courses held by his esteemed mentor Dr Mangubat in Seattle, WA to teach advanced breast augmentation techniques and advanced breast augmentation with breast lift techniques to other cosmetic and plastic surgeons.
Transumbilical Technique
The transumbilical technique uses the belly button as the only natural hidden incision. Many of these girls often go back to office type work in 2 to 3 days. Unlike its inception 20 years ago, this advanced minimal invasive quick recovery transumbilical approach can place the implants precisely and accurately below the pectoralis major “muscle.” After Dr. Cheski pioneered these techniques, he built his practice into the busiest cosmetic breast surgery practice in southern California. He performed over 10,000 transumbilical breast augmentations, including many models and actresses. Dr. Hah felt very privileged to be the last cosmetic breast surgery fellow Dr. Cheski trained in Beverly Hills, CA. Dr. Hah and the other members of Amercian Society of Cosmetic Breast Society are extremely grateful to Dr. Cheski for his selfless support and advancements to our field of cosmetic breast surgery.
It is absolutely delightful to be able to offer the same level of technical precision for rapid recovery hidden incision breast augmentation to our Southeast Texas and Southwest Louisiana gals. Previously, this would have required traveling to and staying a few days in Beverly Hills, CA. From a very important medical point of view, the transumbilical technique also has been reported to have one of the lowest rate of infection as well the lowest rate of capsular contracture. Like piloting a high performance airplane, the transumbilical technique is an advanced technique for breast augmentation that requires advanced training to master and perform well. Just as Dr. Hah felt some of his most outstanding flight training was from USAF fighter pilots, he felt his training received from Dr. Cheski was also on an equally outstanding level. For the right candidate of breast augmentation, this technique does offer some very unique advantages. We also routinely 
perform transaxillary and direct approach incision breast augmentation approaches as well.
Dr. Hah is especially happy with the postoperative results of the transumbilical breast augmentation. Clients who have had this hidden belly button scar quick recovery technique done here in Southeast Texas. After having been selected to study in a two year cosmetic breast surgery fellowship under world recognized transumbilical expert Dr. Peter Cheski in Beverly Hills for this specialized technique, Dr. Hah has been performing this quick recovery technique for many happy clients including nurses, nurse practitioners, teachers, paralegals, legal secretaries, physicians, body builders, waitresses, business owners, plant workers, plant supervisors, as well as our mommy makeover “domestic CEO’s”
Most of our breast augmentation clients take off anywhere from 2 to 5 days for their recovery. Most girls are able to drive in 24 hours. Depending on preference, they often return to office type work 2 to 5 days.
You may also find useful information at Dr. Hah’s Facebook as well as Online Review Physician Review Sites from some of our clients.
Breast Lifts/Mastopexy With Augmentation
Breast Lifts can have conventional incisions (Vertical or Anchor) and even the No Vertical Scar (Hidden incision in breast fold) Breast lifting or Mastopexy is entertained for our clients who have significant drooping of the nipple and lower breast tissue, usually noticed after having children and after breast feeding. If significant drooping is present, placing only breast implants can make the breast look very unnatural with a “Snoopy Dog Nose” look. Sometimes in borderline cases, a lift can be avoided by placing the implant in the subglanduar or subfascial position instead of in our usually preferred under the muscle position to “pop” up the nipple and breast position.
For clients who require breast lifting, we perform traditional as well as hidden incision (No vertical scar)
Breast Lifting. Some of our breast lifting patients add breast implants to enhance their superior breast pole fullness. What we are gaining with breast lifting is a better breast shape, as well as a higher nipple position. The cost for that improvement in shape are the incisions on the breast. If a woman has significant breast ptosis or breast droop, a breast lift may be required to get a more pleasing breast shape as well as a higher position. This situation often presents after having children and breast feeding. Although a more technical challenging procedure, combining a breast implant with a breast lift in some of these clients can be very satisfying to both the surgeon and client.
Most of our breast lift or breast lift with augmentation clients take a week off from work.
Our staff and Dr. Hah will be happy to visit with you during your office consultation regarding these matters in a relaxed and friendly atmosphere.
Male Breast Reduction (Gynecomastia)
Gynecomastia(enlarged or over -developed breast ) in men can be caused by hormonal change, weight gain, hereditary, certain drugs, or obesity. For clients who are interested in Male Breast Reduction, two separate 1/2 inch incisions are made to remove excess tissues. The procedure minimizes the recovery time and patient can return back to work without significant downtime( usually in 2-3 days.)
Dr. Wilbur Hah is a triple board certified plastic surgeon/cosmetic surgeon. He has been recognized in America’s Top Plastic Surgeons for performing Breast Lifting and Breast Augmentation.
His practice has been serving the areas of Beaumont, Texas, Port Arthur, Texas, and Orange, Texas as well as Vinton, Louisiana, Sulphur, Louisiana, and Lake Charles, Louisiana for over 15 years.
He is also listed in Facebook under Dr. Wilbur Hah.
