Benefits of Dual Plane Breast Augmentation

What are the benefits of the dual plane technique? Is it less painful than the other procedures? Does it cause less bleeding, capsule constractor? Faster recovery?

Doctor Answers 23

Dual plane dissection is the key to natural results

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I used to use dual plane dissections only on patients with breast ptosis, or droop, but now I do it on every one of my augmentations.  In my opinion, this allows the most accuracy of implant placement and the best shaping of the inferior part of the breast.  While the differences between the dual plane and a strict submuscular technique are very subtle, they are very real, and I believe the results are consistently better with a dual plane.  Essentially the main difference between the two is that with a dual plane dissection, effort is made to elevate the bottom portion of the breast tissue off of the pectoralis muscle up to the level of the nipple or areolar border.  This accomplishes many things. First, it gives great visibility to the borders of the pectoralis muscle so that maximum muscle coverage can be achieved over the implant preventing "window shading" of the muscle over the implant and extreme distortion of the breast with muscle contraction.  It prevents over-dissection of the pocket, thereby making implant placement more accurate.  It also allows the implant to fill the bottom contour of the breast and produce a fuller, more balanced shape.  It adds a little bit of time to the procedure, in my hands maybe 10 minutes for both sides, but it is well worth the extra effort.  In the short term this results in a more natural shape of the breast, and in the long term it helps prevent the double bubble, or "Snoopy breast, " deformity that occurs when the breast tissue relaxes independent of the implant, and it droops or sags over the implant which retains its position under the muscle.  These are the main reasons why I believe that a dual plane dissection is superior.  The breast is not a submuscular organ, but a dual plane dissection at least allows all of the benefits of a submuscular implant placement while still achieving the advantages of lower pole shape that sub glandular, or above muscle, placement allows.  Hope this helps, good luck.

San Diego Plastic Surgeon

Dual plane breast augmentation

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Dual plane breast augmentation means the top half of the implant is under the muscle while the bottom half lies directly under your breast tissue. Most surgeons use a dual plane technique as opposed to a sub-glandular approach (on top of the muscle). Whether or not there is less bleeding or less pain is mostly related to who your surgeon is. A gentle pinpoint electrocautery dissection (as opposed to traditional blunt dissection) usually results in a relatively pain-free quick recovery. My average patient can have the surgery on a Friday and be back to work by Monday or Tuesday (depending upon the type of work of course!). Dual plane augmentation is reported to have less capsular contracture than sub glandular augmentation. Hope this helps!

Marcel Daniels, MD
Long Beach Plastic Surgeon

Benefits of dual plane breast augmentation

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Great question! When a patient presents with a small amount of breast ptosis (sag) a dual plane breast augmentation is a very effective technique to help avoid the need for a breast lift and still allow the implant to be placed under the muscle. When an implant is placed under the muscle and the overlying breast has some degree of sag the muscle will hold the implant back and not allow it to fill the loose tissue at the bottom of the breast The word dual means two and the word plane refers to the natural separation between two layers of tissue. In the breast there is a natural separation between the breast tissue and the underlying muscle. During a dual plane augmentation the breast tissue in the lower part of the breast is separated from the underlying muscle. The muscle is then released along its entire attachment at the bottom of the breast. The muscle then moves upward like a window shade toward the nipple. With the restriction of the muscle in the lower part of the breast removed the implant is then allowed to fill the loose sagging part of the lower breast. This is a very effective technique to help prevent the need for a breast lift in a patient with a small amount of sag and still have a benefits of an implant placed under the muscle. This technique is also very helpful in the treatment of other conditions with constriction in the lower part of the breast.
Performed properly a dual plane breast augmentation should not have any more or less bleeding than a conventional augmentation. The recovery is the same as is the incidence of capsule contracture.

John J. Edney, MD
Omaha Plastic Surgeon
4.8 out of 5 stars 133 reviews

Dual Plane Breast Implants

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 In essence, all subpectoral breast augmentations are dual plane, in that the implant sits both behind the pectoralis major muscle in the upper inner part of the breast, and behind the breast itself in the lower outer part of the breast. There is no pectoralis major muscle coverage in the lower outer part of the breast so all subpectoral augmentations are in essence dual plane. We use the terms dual plane one, two, and three to refer to the level at which the muscle is separated from the breast. All subpectoral augmentations are at least a dual plane one, meaning that the pectoralis major muscle has been released across the entire length of the inframammary fold. We use dual plane two to refer to a situation where the muscle is released up to about the lower border of the areola. Dual plane three is a release to just above the top of the areola. Which level of release you choose depends on: 1) what the patient is starting with, 2) the implant you are using, and 3) the outcome you are trying to achieve. 

Michael Law, MD
Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 123 reviews

Dual Plane Breast Augmentation

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The term “dual plane” is used to describe an operation when the implant is placed beneath the pectoralis major muscle superiorly but lies directly under the breast tissue inferiorly. This technique requires dissection in both planes and is best for thin patients with moderate amounts of ptosis (i.e. drooping of the breasts) that would be difficult to correct with subpectoral or subglandular implant placement alone.

Jaime Perez, MD
Tampa Plastic Surgeon
4.8 out of 5 stars 81 reviews

Dual Plane Lift

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A dual plane lift, very simply, involves opening the space both behind and in front of the pectoralis muscle.  The structures in the chest of concern with breast augmentation in order from deep to superficial are the ribs, pectoralis muscle, breast tissue and skin. At the bottom of the breast where the surgery is below the lower edge of the muscle there are ribs, breast tissue and skin.  With 'under-muscle' breast augmentation the upper part of the implant sits between the ribs and the muscle.  The breast remains attached to the front of the muscle.  By separating the breast from the underlying muscle as well the breast gland can be elevated beyond it's normal attachment to the muscle.  This in essence places the natural breast tissue over the implant at a higher point giving a small amount of lift to the lower pole of the breast over the implant.  The amount of this lift depends on how much separation is performed.  It is not something I believe is valuable in most cases.  In cases where the breast is a bit 'droopy' then the level of the nipple is typically below the edge of the underlying muscle so a release up to the nipple is meaningless. Additional elevation is necessary to have any effect.  In these cases I usually perform some fixation as well.  I hope this helps.

Scott E. Newman, MD, FACS
New York Plastic Surgeon
4.9 out of 5 stars 42 reviews

What are the benefits of dual plane brest augmentation?

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Dual plane dissection is a technique for patients who either require or want a submuscular position for their implant but have enough "droop" the the breat tissue that might look strange after a pure submuscular technique.  The dual plane can allow the breast tissue to ride up relative to the implant so that it doesn't look like the tissue is "hanging off the implant.  It preserves the benefits of the submuscular position such as lower visibility of the implant and less capsular contracture without having to add the scars of a "breast lift"  It doesn't hurt any more than a standard submuscular technique.

Neal Goldberg, MD
Westchester Plastic Surgeon

Dual plane breast augmentation- a nice combination of techniques

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Dual plane breast augmentation is a nice combination of submuscular breast augmentation (where the implant is placed below the pectoralis muscle) and the subglandular technique.  Submuscular augmentation allows for better coverage of the upper half of the breast implant.  It is particularly beneficial in patients who do not start out with a lot of breast tissue of their own.  It is also associated with lower rates of capsular contracture or scarring around the breast implant.  Overall, a subpectoral breast augmentation is somewhat more painful, as the muscle must stretch to accommodate the implant. Nevertheless, patients usually recover very quickly from both techniques.  (I once had a patient bake me cookies on the first day after a dual plane breast augmentation!)  The "dual" plane part of the phrase refers to releasing the glandular breast tissue from off of the pectoralis muscle in a submuscular augmentation.  This allows the breast tissue to fall more naturally over the implant. 

B. Aviva Preminger, MD
New York Plastic Surgeon
5.0 out of 5 stars 6 reviews

Dual Plane pocket for Breast Augmentation

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Dual plane breast augmentation is my procedure of choice. It is really a submuscular plane superiorly and suglandular laterally. The benefits are less capsular contracture and rippling. The cons are that it is more painful and probably has a slightly higher chance of hematoma. Most women get a dual plane breast augmentation.

Leo Lapuerta MD

Triple Board Certified Plastic Surgeon

Leo Lapuerta, MD
Houston Plastic Surgeon
4.3 out of 5 stars 48 reviews

Dual Plane Breast Augmentation

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I feel virtually all submuscular breast augmentations are in fact dual plane.   The pectoralis muscle is only going to cover 65% of the implant or less and the rest of the  area ort the dual plane.   No, it does not hurt more or less and the risk of complications is not different.  This is basicall a simple sub muscular placement to which has been added a new name.  Go for it.  It is generally called sub muscular and it works better tham the sub glandular.  Less contractures.  Good Luck.

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