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Can You Perform a Dual Plane Breast Implant Procedure Through a Nipple Incision?

asked 10 months ago by Auntie-shop in Ex-pat in China
Latest answer by E. Ronald Finger, MD
Question viewed 837 times
Tags: areola incision, dual plane, options

I had implants in Shanghai. I can feel the edges on one side and bottom and they are slightly uneven, but other than that I was pretty happy. I told my family Dr what I had done and he laughed and said it could not be under the muscle if the incision is around the nipple. Have I been misled? I was told that the surgeon used a dual plane procedure. Now I am a little concerned - should I be feeling the implant edge so easily? I can also feel a bubble under the side of my nipple!

17 answers to Can You Perform a Dual Plane Breast Implant Procedure Through a Nipple Incision?

Dual plane breast augmentation

Yes, it is possible to do a dual plane breast augmentation through the nipple. A dual plane technique is by definition having an implant that is both above and below the muscle at the same time. When the pectoralis muscle is detached from the inferior border of the breast, the muscle retracts superiorly. This means that when the implant is placed in the breast pocket, the upper part of the implant is covered by muscle and the lower part is covered by breast tissue. more

Wilberto Cortes, MD
Houston Plastic Surgeon

Dual plane and peri-areolar approach

Hello, Subpectoral, subglandular, and subfascial placement of the implant can be achieved through inframmary, periareolar, and transaxillary incisions. Dual plane is essentially a subpectoral position. All the best, Dr Remus Repta

Remus Repta, MD
Phoenix Plastic Surgeon

www.aaaplasticsurgery.com

Can You Perform a Dual Plane Breast Implant Procedure Through a Nipple Incision?

Your doctor is mistaken. Submuscular, dual plane, and prepectoral (premuscular) positions can all be performed though the periareolar incision. However, if your implants are soft and movable, I would not re-operate on them because you can feel the edge of one of the implants, particularly if you are pretty happy with them. All surgical procedures do carry some risk. If they must be replaced in the future for any reason, you can have them placed behind the muscle through the... more

E. Ronald Finger, MD
Savannah Plastic Surgeon

Dual Plane Breast Augmentation and Periareolar Approach

A "dual plane approach" simply means that a portion of the breast implant is covered by the muscle, and a portion is covered by the breast glandular tissue. This can be achieved through a peri-areolar or infra-mammary approach. With regard to the "edges of the implant" you are feeling, I would recommend that you see a plastic surgeon to determine if what you are feeling is truly the implant, and whether this can be improved.

Richard Ellenbogen, MD
Los Angeles Plastic Surgeon

Dual plane breast implant placement can be done through peri-areolar approach

Your left breast looks a bit 'flat' in the lower pole, as if you had a mild constricted breast shape on that side. Tough to say without pre-op photos. I don't think that doing from sub-glandular to dual-plane placement is going to help your breast shaping. It may help soften the palpable edges of the implant. Dual plane placement through a peri-areolar incision is commonly done.

Scott Sattler, MD
Bellevue Plastic Surgeon

Yes it can

Implants can definitely be placed under the muscle from the periareolar incision (like you have). It looks to me that the fold below your breast is at a different height on each side - this is likely something that existed beforehand. Feeling the rippling at the bottom or side is more common with saline than silicone so you may want to change to silicone if you have saline. You will always feel your implant on the bottom where the muscle doesn't fully cover the implant,... more

Bivik Rajnikant Shah, MD
Columbus Plastic Surgeon

Dual plane augmentation via periareolar incision is common. It is uncommon for family physician to give plastic surgical advice!

Shame on your family physician! Not only was he wrong, but his conduct towards a colleague physician whose specialty he has incomplete understanding of was totally inappropriate if not unethical. Your surgeon has told you the truth, but the result he has achieved is suboptimal (thus far). I would begin wearing an elastic bandeau above the left breast and below the right breast at night to aid in downward implant movement on the left side. Over time this may improve to a degree that... more

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon

Dual plane through th areola

Funny! I do that all the time. It is very easy to do it through the areola. It can be doen through other approaches as well.

Steven Wallach, MD
Manhattan Plastic Surgeon

Worries about placement of breast implants

Your family doctor should be embarassed. Not only was he wrong, but it was inappropriate to laugh at the work of another physician and alarm you. He should have referred you to a board certified plastic surgeon in your area for accurate evaluation and information. Many, many surgeons do subpectoral or dual plane breast augmentations through peri-areolar incisions. The muscle only covers the upper inner half of the implant and so your implants can be more easily... more

Lori H. Saltz, MD
San Diego Plastic Surgeon

Can You Perform a Dual Plane Breast Implant Procedure Through a Nipple Incision?

Yes it can. Your issue is a poorly preformed augmentation with very little attention to detail and symmetry. I base this on your posted photo. Seek a second opinion.

Darryl J. Blinski, MD
Miami Plastic Surgeon

Fixing breast asymmetry

Your posted photo shows asymmetry with the left nipple further from the midline than the right, the left breast slightly smaller than the right and the fold under the left breast slightly higher than the right. This is what you call uneven. I suspect these were present before surgery and you would be happier now if they had been adjusted during surgery to make you more symmetric afterward. Sometimes asymmetry is very slight before surgery and not noticed unless the surgeon takes the time to... more

Aaron Stone, MD
Los Angeles Plastic Surgeon

Dual Plane Breast Augmentation can be a preferred technique

"Dual-Plane" or "partial sub-pectoral" breast augmentation is my choice of breast augmentation techniques. It can be performed through practically any common augmentation approach, including areolar and inframammary incisions .A small one to two centimeter strip of the pectoralis muscle is divided creating two implant pockets. From the level of the nipple superiorly, a subpectoral pocket is utilized, whereas from the level of the nipple inferiorly, a subglandular pocket... more

Jeffrey D. Hoefflin, MD
Los Angeles Plastic Surgeon

Can dual plane augmentation be done through a nipple areolar incision?

Yes it can, and that is my personal preference. Your family doctor is wrong in what he told you. If you tighten your chest muscles and the breast implants tend to move slightly laterally, then they are under the muscle. You have some asymmetry, with the left side being smaller (most likely this was present preoperatively as well). If you feel the implant bubble under the nipple is because your tissues are thin or the breast tissue was not closed under the skin. Silicone gel implants might be... more

George Marosan, MD
Bellevue Plastic Surgeon

www.bellevueplasticsurgeons.com

Dual plane breast implant procedure through the areola?

Dual plane breast augmentation can be performed through an areolar incision. It is important to note that the muscle only covers the front, top and medial portions of the implant. The inferior and lateral portions of the breast do not have muscle coverage when the implant is placed under the muscle. Saline implants can be felt through the skin easier than silicone implants in these areas.

Frank Agullo, MD
El Paso Plastic Surgeon

www.elpasoplasticsurgery.com

Dual Plane breast augmentation through a "nipple" incision

A dual plane or sub-pectoral breast augmentation can certainly be performed through an areolar (nipple) incision. Of course, your implants may be subglandular (above the pectoralis muslce). Switching to silicone gel filled implants would make the implants less palpable. If your implants are above the muscle then switching them to a subpectoral or dual plane position would also help to decrease the palpability.

Laurence Weider, MD
Dallas Plastic Surgeon

Breast augmentation

Yes sub pectoral and dual plane can be done through a areolar incision. Your family doctor is wrong. If you have saline they are more palpable. You do have some asymmetry in the picture as well. Both could be improved if you have saline and switch to silicone.

William Alan Dulin, MD
Dallas Plastic Surgeon

Breast Augmentation through periareolar incision

Yes, dual plane and sub-pectoral breast augmentation surgery can be done through an "around the nipple" (periareolar) incision, depending on the original diameter of the areola and the choice of implant type and size.