It is probably not the dual plane or other technique but rather tension created by placing a very large implant often seen with inadequate soft tissue coverage, seroma, hematoma, infection, and other factors.
Implant exposure is usually too large of an implant with in adequate soft tissue coverage or an overt infection, dual plain is thought to help against sagging
plane placement is not the cause of implant exposure issues. Typically an
exposed implant is a result of impaired tissue quality in the breast region.
Thank you for your question. Especially with large breast implants such as you chose, dual plane rest augmentation is the preferred method to allow the overlying breast to redrape properly on top of the muscle mountain created by your implant. I am unaware of any information that would suggest dual plane breast augmentation has any negative effect on incisional healing. Using very large breast implants is a more likely cause of your incisional problems.
Thank you for your question and photos. There are many factors that can affect wound healing and thus threaten implant exposure. The location of the implant really plays no major role in this. The greater risk for exposure comes from implant size (larger implant), patient history of smoking, diabetes, tissue disorders, infection, etc. Always best to follow up closely with your surgeon who knows you best.
Best of luck.
The pocket positioning of your breast implants is not the reason you would have had an incisional breakdown. Most breast augmentations today are done in the dual plane location and the incision is often located very near the non-muscular coverage portion of the pocket. If the implants are very large and are placing the skin under a lot of tension, the incisional closure may be at some risk and thus implant exposure can occur if it opens up. This appears to be the issue in your case.
Thank you for your pictures. Your wound breakdown is unlikely due to your dual plane placement. Wound breakdown can occur due to inadequate technique, infection or tension as examples. Continue to follow up with your plastic surgeon to insure a good outcome.
Earl Stephenson, Jr, MD, DDS, FACS
I am sorry to hear about the experience you have had. I do not think that the “dual plane” positioning of your breast implants has a specific role to play when it comes to the “near exposure” you have experienced. Keep in mind, that the vast majority of breast implants placed today are placed in this position. More likely, the issues you are experiencing are related to the size/profile of the breast implants utilized, in relation to the overlying breast skin envelope. Of course, your plastic surgeon will always be your best resource when it comes to more precise answers/thoughts. Best wishes.
It is very unlikely that a dual plane procedure would have anything to do with the issues that you are having. I perform a dual plane procedure in nearly all of my breast implant operations and have never had any such complications. That said, your implants look very large and perhaps are putting extra strain on your tissue that cannot accommodate such a large prosthesis. Additionally, the upper pole of your breasts seem to have a pretty sharp transition from chest wall to breast which is not the way a dual plane procedure usually looks. The dual plane gives a very natural outcome in my hands. This sharp transition in your case again could be because of excessively large implants, but my suggestion is to get a local second opinion from a board certified plastic surgeon as your situation is not straight forward.
Thank you for your question about your breast implant healing.
It is hard to tell without an exam and review of the operative note but your photo suggests that your implants are very large for your frame. It may be that the size of the implant was such that it would not fit under the muscle and a dual plane was needed. Too large an implant puts tension on the tissues and increases the risk of poor healing. With such large implants, drooping over time is very likely - under the muscle or dual plane. Best wishes.