IamA foremost expert in Trans-Umbilical Breast Augmentation(TUBA) surgery in the world with over 20,000 Surgeries over a twenty year career AMA!

Second question: What's the most ridiculous request you've ever had from a patient?

There is such thing as patient confidentiality, so I cant give names. but... I've had a male patient ask me for TUBA. It was a strange case... But I took it.

Was that the guy who lost a bet?

Maybe, can't say for sure. I can't remember what the circumstances were, but I never forget the one time I performed tuba on a man.

Was it on Brian Zembic?

This guy.

That's Photoshop

What, those black stars aren't his actual nipples?

As if you have to ask.

Is there a lot of psychological preparation for patients who go into surgeries like this for the first time?

usually there is no such psychological preparation for this procedure. When patients come in for consultation, I usually do my best in consulting to make sure that the patient feels comfortable with this decision before they undergo treatment. Many patients are not ready to undergo this surgery and it becomes apparent as the days arrive. they have questions, and all we can do is prepare them and make sure that this is the correct decision.

How much does the price differ from your standard breast augmentation? Why and how did you create the TUBA process?

Prices may Vary depending on the patient's case, what you should do is call our number 1800- 340 - 4095 and tell them that you came from the reddit IamA event. As to why I created it. I was part of the research team that developed it. The process was created because regular Breast enhancement surgeries has too many scars. You can always tell when the breasts were done thru regular Breast enhancement. I created this process with my colleagues because women want to look feel great without having to scare their bodies. You will have a hard time telling when a woman has had TUBA surgery.

Can you give us any idea as to average cost? Are we talking 5k? 20? 100? I have no idea and ive always been curious

Depends on size of implants and patient, on the average it doesn't go beyond 5k. I can't give you an exact number but since this procedure is faster than the usual breast implants it is a lot more cost efficient. Plus my finance guys came up with a plan were you can pay off get the surgery for $87 per month, after six months. Most people do not do plastic surgeries because surgeons keep asking for all the money upfront, our goal is to bring the best results, but also to make them affordable. So you probably will pay much less than you imagined. Give us a call, if you want more info. 1.800.340.4095

$87 x 6 months is only $522. Did you mean 60 months?

Meaning that the first 6 months you don't need to pay anything. like in the furniture stores. This price things are best left to the finance team. If you like give them a call at 1.800.340.4095 and ask them about it, but I do know that this is a special we have right now. I do this for the love of the art, but I have to pay the bills like everyone else.

Why would the cost vary?

Depending on a number of factors, I'd think:

Size of implant, saline vs. silicone, over- or under-the-muscle, etc.

what he said.

When I had mine done 10 years ago, the surgeon told me he wouldn't do TUBA because he felt the incision site was too far from where we were working. Meaning he felt staying as close to the breast as possible was safer & easier. I had mine put in through the underarm. Wouldn't going through the belly button have many more risks? I remember I lost feeling on the underside of my arm near the incision for a while. Could this happen to the stomach area?

Its a complicated procedure and part of the fear of tuba comes from the relatively few people who actually know how to do it. 20,000 patients latter I can tell you that It is indeed less intrusive and far more effective. But it depends more on the surgeon's hand. Cutting the area of the nipple is far more dangerous and can have further complications in the long run.

Just kind of curious, for breast reduction, are you only limited to cutting at the nipple and on the breast?

Some surgeons cut below the breast, it puts an ugly scar. The idea is to avoid it whenever possible.

I see. My girlfriend recently had it done, and they sort of went about it in an anchor-shape cut if that sounds correct? It's been a tad worrisome for me because like you said, it's caused some pretty bad scarring. Would there have been another way of going about it though?

Definitely. I created the TUBA procedure to avoid this scaring. Eventually the scars make them feel uncomfortable. I also do reconstructive scar surgery to remove or minimize the scars after a surgery. If you like give us a call and we can do something about those scars. I hate to hear about what happened to your sweetheart. This is our office phone if you would like to talk. 1.800.340.4095

1) what makes it so much "safer"?

The Tuba Process has a quicker recovery rate because they are not slicing thru breast tissue and muscle , they are just going straight thru the belly button, wish is also better for scaring, no slice marks on their beasts, they are working with the original scar wish is the Belly button.

This whole thread reeks of a corporate PR stunt . . .

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Is it any different than an actor doing an AMA and promoting their new film? They give answers, in return they see some free advertisement. Who's being hurt, here?

That's what I though, and I have answered many questions here too. I dedicated the whole day to this activity. Its a day were I did not perform any surgeries, Just focused on reddit. My time is precious and I hope you guys can understand the sacrifice I had to make to be here.

Well, you are the first Redditor to pass up playing with boobs to get on Reddit... haha

Well its no game, but I see your point.

How many user names do you have?

It was a mistake. The guy who created this up for me logged me in. I am not tech savi and have to reply on a guy to help me with this. He told me that I was logged in with the wrong user name and to prepare for this question. So yea... sorry. To be honest I agreed to this thinking I would get one or two questions, Little did I know that it would be so interactive. I have enjoyed this very thoroughly.

Haha! I figured it was something like that, I just wanted to mess with you. Thanks for the AMA!

No, thank you. I needed a day off anyways.

How many surgeries do you do in a normal day / week? How long do they normally take? (I am guessing not long if you can do 20k in 20 years).

I do from 9 to 5 cases per day. On some occasions I may even top 15 cases in one day.

Do the maths and holy shit, that's nearly 3 a day average for 20 years.

Assume the man is only in theater three days a week and that's six augmented breasts before lunch EVERY WORK DAY.

Yeah that's why I assumed they must be relatively quick procedures. Especially considering that for each of those clients there was a consultation prior to the actual procedure. He has had a full schedule to say the least!

Yeah, I follow your logic. Wow, that's scary fast. :S

A TUBA surgery can be done as fast as 30 - 45 minutes.

Once you've done 20000 of them i would imagine you get pretty damn efficient. Hell, your more practiced at this than i am at masturbating.

True enough. I love what I do.

Was being in school till your thirties possibly damper your life in any way, as in would you do it again?

I am glad with the choices I made in life, and one does not really ever leave school. My research team was sponsored in part by FIU and other local Universities. I also used to teach a class at a community college.

thats like 1000 surgeries a year bro, holy shit

That is correct, some years more than that. It started after media noticed my work. This is an interview I gave on national Television in Spanish. http://www.youtube.com/watch?v=gxw_HScK-pY

I have a couple questions. I am a woman in her mid 20's and had breast augmentation 2 years ago. 32A to a 32C. I do not regret the decision to have an augmentation, but sometimes I'm... less than ecstatic about the end result. I was talked into the inframammary incisions when I originally was concerned about scars and wanted axillary (TUBA - sadly - was not an option). I have learned to accept the scars - a price to pay for a more proportionate body - but continue to be frustrated by the large gap between my breasts and how "non-real" they feel. I opted for saline (partially for safety and partially for monetary reasons) and to place the implants under the muscle (so I knew for certain I could breast feed when the time came). Now I have some regrets because these choices resulted in a less than life-like result. I wonder about a "redo" and what the risks/benefits could be, and how long I should wait.
Any suggestions or words of wisdom?

I'm sorry to know your story. However, there is always light at the end of the tunnel. You are a special case that I don't see often and I have to personally look into your condition to be able to correctly assess the right course of action. Feel free to call our medical advisers at 1.800.340.4095 they will put you in contact with me and then we can further discuss your case. I'm almost positive I can help you out.

I'd like to ask who has been editing wikipedia for your benefit today and on the fourth? Did you hire 'Fernando Blanco' to "manage your brand" on wikipedia, or is the fact that his account a couple of days old going to confuse these people? Seriously, a person saying he's been on Wikipedia since 1999 when it was launched in 2001? And when his account page is a few days old?

Seriously, this reeks of dishonest self-promotion. Manipulating Wikipedia to include your photo and weird information about your dermatology school? Check. Linking said information to a website which you are a partial owner of? Check. All edits made by a new account claiming to have been started before wikipedia? Check.

That's my media guy. Not sure what he's been doing. It was his idea to set this up. I told him about the wikipedia thing, He's kind of clueless when it comes to days, thanks for letting me know.

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I had to forgo many things to get to where I am. Things that were valuable to me as a person, and I'm not just talking about going out and having friends. Loved ones, times when i had to stay behind and put work before family, before friends, before loved ones. But in the end all the sacrifices were well worth it. I am happy with my life, although there are some things I would do differently would I have a chance.

You may have already answered but what is the advantage of TUBA compared to incision at other sites? Are implants placed beneath the pectoral muscles?

The main benefit of TUBA is the size of the scars. When comparing to the traditional breast augmentation, TUBA is done through the navel (belly button) which leaves only a tiny scar in your belly button VS others that leave much larger scars in more visible areas.

I've recently discovered that I had always been wearing the wrong bra size, as most stores only stock 32-38 A-DD, and most women in fact do not fall into these measurements (thanks, /r/abrathatfits !). I'm wondering if you go by these "traditional" bra sizes when doing implants, or if you use the actual chest-to-rib measurement to determine the new bra size? Because it would be a real shame to put brand-new awesome boobs into a poorly fitting bra.

We determine the implants by the size of the torso and the current breast size, Sometimes women ask for unnatural sizes that are too large for their frames to hold.

Thanks for the reply! With all the misinformation out there about breast/bra sizes, do you find you have to educate women on what those bra sizes actually look like? (For instance, I have a very small-breasted friend whose actual bra size is 28-DD, but she'd been wearing a 32-A for years because "that's what size small boobs are!")

True enough the wrong bra size can have very negative effects on the patient. It is important for women to be educated about their bodies and understand what is right for them and what makes them feel comfortable.

Did you ever turn a woman down because her boobs were just absolutely perfect already? Or maybe just talked her out of it?

I never turn down patients but I do provide accessory before undergoing a surgery to make sure it is the right decision. Sometimes women are pushed into this surgery because their husband are not satisfied with their look. We always do consultation to make sure that they are fine with their decision and also healthy enough to have surgery done on them. It depends on the patient.

What is your opinion on breast enhancement and augmentation using stem-cell enriched fat?

Is it legit or is all bull?

As far as I know, Stem-cell enriched fat in the USA is used for clinical purposes, like arthritis, Kidney failure, skin therapy, but you don't use it for breast augmentation.

What gave u the idea to become a surgeon. Or to specialize in cosmetic surgery. Ive recently graduated and havent really decided on my residence. How do you know that one will perform well in a certain field in medicine.

I have always been artistic, drawing , art, and to me plastic surgery is a form of art, My canvas are my patients. And I feel pride and joy to see the end result of my work. Once you find that one field that makes medicine feel like art. You will now what to specialize on.

Why are there two people answering the questions?

I signed in with the wrong login credentials, I am not tech savi and signed in with the reddit account of my tech guy, I am an old man and this computer things are hard for me, So I asked one of the new guys to help me out. He told me to prepare for this question because I signed in with his account instead of the one he made for me. Sorry.

Just wondering :) Was a tad confusing.

My mistake. :)

Odd question, probably, but here goes.

As musicians become musicians, they often find themselves breaking apart the music they listen to, without realizing it. Artists find themselves staring at their surroundings, imagining a photograph, painting, etc. People tend to lose sight of the beauty of things as they begin to learn what makes them tick.

That said, has your work made you perceive women's bodies in a more....clinical fashion, on a day to day basis? As in, subconsciously looking at the Starbucks barista and thinking of what you would do to make her look better. Sorry if this question doesn't really make sense.

Honestly, I see women, as patients, That being said, there is a Starbucks next to my clinic and I cant help but play around with the Starbucks Logo, I hate to admit it but you hit on something that I do on a day to day basis. I also can tell just from sight the real and fake breasts.

No reason to be ashamed of it! The body is your canvas, so you can't help but look at every canvas you see and think of a way to improve upon it.

Hell, I've always wanted to go to a plastic surgeon and just ask "What would you do, money is no issue?"

Come over sometime. These now a days surgeries is not as expensive as people think.

Can you do a TUBA type operation for a reduction, or is it only for enhancements?

TUBA is only for augmentation surgery. A reduction is a completely different surgery.

What do they feel like?

... like real breasts. what exactly do you ask?

Revision rate in 5/10/15 years / capsular contraction rate?

I assume these are over the muscle?

Successful lactation rate?

Revisions are suggested every year, about the implant the manufacturer warranties it for 10 years,but that doesn't mean you have to replace it at 10 years, it could last much more than that, about the capsular contraction it depends on the patient.

to answer your second question, it is Under the muscle.

Successful lactation rate? 100%

Do you consider these to be natural looking? http://my-vanities.com/breast-augmentation-photos/

Many patients do ask for things that are unnatural. As long as they are withing the possible parameters I do give them freedom to choose.

Is your name Ronny Johnson?

no....?

What was the youngest patient you have performed augmentation on?

I can't give specifics because of patient confidentiality,but she was 16 years old. It is recommended that you be at least 18 but with parental consent it can be done as far back as 16 years of age.

I was only interested in the age. Just curious what age women start feeling inadequate with their figures. Thanks.

Understood. Many young girls who want to enter modeling prefer TUBA to regular breast implant surgery because it does not leave that huge hideous scar on the breast. Also the recovery time is much shorter and causes less damage to the breast.

i have to ask - does any breast implant or augmentation do really feel the same as natural breast? I had one time experience with lets say "fake tits" and i have to admit that it wasn't all the same i thought it would be and i even have to admit it was a mood killer to get to know they were fake. i could feel the edge of the breast and it was really weird.

The natural feel of breast may depend on which implant the patient used. Although, the feel is quite similar between both implants, silicone implants feel more natural.

What is the most likely complication from this procedure, and what is the worst least likely complication?

there are very few complications. only in extremely rare cases, but the benefits are many. No visible scars, Quick recovery time. Needless to say that there are more risks in regular Breast enlargement surgery. We minimize the risks by carefully assessing each patient and their clinical history before proceeding.

How do you handle someone that tends to keloid?

Before any surgery, we perform several tests, and if the scarring process will not be adequate, we take the necessary steps to minimize damage. Also since the insertion is on the umbilical scar, the chance of Keloid is very minimal.

TY

I'm sorry, I'm new here, what does TY mean?

It means thank you.

Understood. TY

• Average skin to skin surgical time?
  
• Do you use local anesthetic field block or rib blocks intra-op?
  
• How do you open up the pocket - with balloon dilators or sounds? I imagine direct vision isn't possible.

It takes from 25 - 30 min. We use general anesthetic. As for your third question, this is done with a special tube that makes a space under the skin, inside of which the implant is introduced.

I work with a few cosmetic surgeons, and they use local in addition to GA to reduce the amount of drug during the procedure, and for initial post-op pain control.

Nice, quick surgery! Need an anesthesiologist?

Indeed we might need one, give us a quick call and let them know who you are. 1.800.340.4095 Tell them that you're from reddit.

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I am glad to be of help. I honestly did not think i would enjoy this experience as much as I have. Its my first time on Reddit and I love all the different cases you folks have brought up.

At 20,000 surgeries averaging $5000 each means the good doctor has earned $100,000,000 in the last 20 years or roughly $5 MILLION per year. I'd say boobs are a gold mine.

... I also have to pay my employees and the rent, mortgage, and the rent on the office.

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Depending on the patient, we can use both Silicone and Saline or either one. Please remember, the main motivation to get a tuba surgery is the lack of scars this surgery leaves, regarding the type of implant someone is eligible to get, this can be found out only after patient's checkup.

"TUBA can only be done using saline-filled implants."

From your website. Perhaps you should update it?

What I meant is that Saline and silicon are not for everyone, if a patient doesn't meet the requirements for Saline implants, that patient has to go with Silicone. Just to clarify,TUBA is always performed with Saline.

How much do you usually make a year? 6 figures?

My tech guy told me to to say.

Serious question: How did you manage to average 1000 procedures per year? 3 per day almost? holy cow!

The procedure only takes about 30 minutes, its not that fast. But since I'm one of the few doctors who does it, I get a lot of patients.

Do you do other kind of plastic surgeries or only breast augmentation ? What do you think of the surgeons who do, for example, Operation Smile? http://www.operationsmile.org

As I told someone else on this forum " A plastic surgeon wears a lot of hats, We are reconstructive surgeons, who fix really sad conditions like leporine lips, cancer survivors, accidents survivors, women who have too many pregnancies and their bodies are deformed by it. That's the help I give. and this for me is more than a job, its a way of art. Plastic surgeons also work on the dermatology, cosmetic surgeries, reconstructive, I can go on forever."

What's the funniest/most horrifying/most memorable thing you've seen on reddit?

This post is my first time, I will start appearing more often from home, on my free time, any recommendations. Once the clinic closes down I'm a regular guy. To be honest this was the first I've heard of reddit. A new marketing guy settled this up for me. Its been fun, but so time consuming. But I agree to dedicate the whole day to this, and I plan on doing it.

Thats well over 2 per day for 20 years if you worked every day of the year. But assuming you didn't work weekends and took off the normal bank holidays, that's at least 4 per day.

I actually do from 4 - 10 surgeries per day, of those about 6 are TUBA. I'm a busy man.

Apparently slow. How long do they last?

About 30 Minutes.

TUBA - good procedure to know about. Thanks for posting.

I'm glad I could be of help. Tuba was not a popular procedure, and even now there are very few surgeons who practice it.

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Thats a relative question, The ideal breast size is the one the patient feels more comfortable with. Whatever makes them happy and its not a health risk.

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I guess a more direct answer was in order.

Has there been much work done that you know of in terms of less invasive breast reduction surgery?

Its a procedure that is relatively new. Our colleagues and I are among the few surgeons who can perform this surgery. It also requires a level of experience that some of the other plastic surgeons just do not have.

What does it entail?

During TUBA, the incision instead of being around the crease(surrounding the nipple area) a short J or C shaped incision will be made within your navel(belly Button) and an empty saline breast implant will be inserted and filled to your desired size with sterile saline. You may read more about it on my work site http://vanitymiami.com/transumbilical-breast-augmentation/ I hope this helps answer your questions. If you have more specific questions I am glad to answer them.

What's the largest breast size you've made?

Edit: I tried to phrase this question as eloquently as possible...

it ws a 46D on a 52'' Bust 49'' Rib Cage, Size is relative, depends on the body type. I have done some smaller breast sizes on smaller torso that appear bigger than. Larger breasts on larger frames.

Thank you. Just....thank you so much.

Ask me anything you like, I will try and answer it as best I can.

What was his name?

I cant say, I'm so sorry, But the HIPPA law prevents me from giving out patient information. Just know that you will never be able to tell who was one of my patient just by looking.

my god man you look creepy as fuck, go shave that "beard & mustachio"

I guess I have been too focus on other people's image.

No question, I just wanted to say that as a cis-Umbilical Breast Augmentation I support your struggle against the Titriarchy. I believe that all trans people, including trans-Umbilical Breast Augmentation, deserve the same rights as those that identify with the breast augmentation they were born with.

Titrarchy?

Tits or ass?

Not sure what you are asking.

I believe he is either he's asking if he's a man who prefers "tits or ass" or if the implants go into the tits or ass.

Tits.

Who decided to call it Tooba surgery?

Its not TOOBA its TUBA, wish stands for Trans-Umbilical breast Augmentation.

Why did you go into plastic surgery instead of using your skills to help people in need?

People who want plastic surgery are in need. They need to fill a philological state that only plastic surgery can give. TUBA surgery is my specially but I have also done reconstruction surgery on breast of women who had mastectomies (breast removed due to breast cancer). A woman who has to forgo her breasts after surviving Breast Cancer. Women often undergo a very traumatic stage and cosmetic corrective surgery can bring some of that self-esteem back to the patient.

Really? It's hard for me to imagine how somebody who can afford tens of thousands of dollars for a breast augmentation is "in need." Edit: reconstructive surgery aside

This surgery is not as expensive as you think. Please keep in mind that as a human being , you are not only in need of money, but also of other things like: social acceptance, self-esteem,etc.

You've taken your brilliant mind (brilliant enough to be a surgeon, at least), and wasted it on tits. There's so many things wrong with this its hard to know where to even start.

Maybe if you actually applied yourself to HELPING PEOPLE IN NEED rather than those who just want you could have contributed to some real medical advancement.

Not to mention you, and your entire profession contribute GREATLY to the public image of a "woman" that females everywhere have to contend with.

My question:

When was the exact moment you decided that you didn't care about helping or healing, but were just in this for the money?

I already mentioned in one of the above comments that my profession helps a lot of people. A plastic surgeon wears a lot of hats, We are reconstructive surgeons, who fix really sad conditions like leporine lips, cancer survivors, accidents survivors, women who have too many pregnancies and their bodies are deformed by it. That's the help I give. and this for me is more than a job, its a way of art. Plastic surgeons also work on the dermatology, cosmetic surgeries, reconstructive, I can go on forever.

A plastic surgeon wears a lot of hats,

Not this guy. He deals ONLY with AUGMENTATION. read his damn comments ffs.

I do not only do TUBA surgeries, although I specialized in them. If you read the above comment, I also do reconstructive work, Dermatology, and Cosmetic surgeries.