Benefits of Dual Plane Breast Augmentation

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.

Dual plane approach provides a good "take off" to the upper portion of the breast without that fake look that plagues total sub-pectroal technique.  It is my preferred technique and may become the standard of care in the future.  Any time I can do it, I do it.  A few patients require alternative placement for several reasons.  

Thank you for your question. The main benefit of the dual plane breast augmentation technique is that it creates a little bit of lift without requiring additional skin incisions. However, it is not a replacement generally for a breast lift (mastopexy). It is not known to be less painful, cause less bleeding, have faster recovery, or have lower risk of capsular contracture.In my Guide to Breast Augmentation on my website, I describe the technique in more detail if you would like to investigate further. See the web reference below.

Dual plane breast augmentation is one of the many
options available for patients undergoing breast augmentation surgery. This
procedure offers significant benefits for patients with specific anatomic
findings and aesthetic goals.

It’s not unusual for plastic surgeons to encounter
patients who have breast hypoplasia associated with mild breast sag. These
patients want larger breasts but don’t want the scarring that’s frequently seen
with breast lift surgery.

Under these circumstances, dual plane breast
augmentation offers significant advantages. This procedure creates a pocket
beneath the pectoralis muscle as well as a separation between the muscle and
the overlying breast tissue. This results in the implant having muscle coverage
superiorly and breast tissue covering the implant inferiorly.

This configuration allows the breast tissue to cover the
implants in a more natural way. It avoids the need for a breast lift and avoids
a snoop dog or double bubble deformity. In addition the patient continues to
have the advantages of sub muscular implant placement including a decreased
risk of capsular contracture.

If you’re considering breast augmentation and have mild
breast sag, you may be an excellent candidate for this procedure. Under these
circumstances it’s important to discuss this issue with
your plastic surgeon.

 For cosmetic Breast Augmentation, the dual plane technique refers to the implant being partially beneath the pectoralis muscle. As the lower part of this muscle is above the lower lateral part of the breast most Subpectoral implants are in fact to a degree dual plane although erroneously often called total submuscular. However, the degree of the implant is beneath the muscle on top and soft breast tissue below can be altered by making the submuscular pocket higher up the muscle leaving some of it below the implant below and some above. The advantage of this is to expand the lower pole of the breast if short or more often for mild drooping breast correction.

Dual plane refers primarily to the placement of the breast implant during surgery. The term, coined by a Texan plastic surgeon back in the late 90s, is defined as a breast augmentation procedure that involves placement of the breast implant behind the pectoralis major muscle and partially behind the breast tissue overlying the muscle. The implant sits on two levels inside the chest, which is why it's called "dual plane". Alteration of some of the pectoralis major muscle is also performed to achieve optimal improvement of the breast as well as allowing for a subtle lift for patients with minor drooping (ptosis). This type of implant placement can be performed with any incision (inframammary, transaxillary, or peri-areolar).Dual plane breast augmentation was designed so that the benefits of both subglandular and submuscular placement could be obtained for the patient. The top 2/3 of the breast implant is placed below the pectoral muscle. The muscle provides more coverage so that the implant is less visible and less palpable, lowering the chance of rippling and a visible upper border (the breasts won't look like they're bolted on as much). It gives the breast that nice natural slope.The bottom 1/3 of the implant is placed under the breast itself in the subglandular position. This allows the breast tissue to drape around the implant, contouring itself to the roundness and thereby adopting a pleasing fullness that better emulates a natural breast shape. There are several varieties of dual-plane augmentations that subtly differ one from the next (there are types 1-3). You will receive the most suitable one depending on your goals and the expertise of your surgeon. 

It's simpler just to think of dual plane as under the pectoralis muscle. The muscle covers the top half of the implant and the rest of the implant is covered by your breast tissue. Completely under the muscle involves lifting a small rib muscle and a small stomach muscle as well. Most plastic surgeons don't do this but only place the implant under the pectoralis muscle. A true dual plane procedure involves loosening the muscle from the overlying breast tissue. But  this is a technical detail and I think it's simpler for you just to think in terms of above the muscle , under the muscle ( pectoralis ) and completely under the muscle . Most plastic surgeons will say that under the muscle is better for  a more natural appearance, less chance for capular contracture and better for mammograms.

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

Dual plane augmentation (partly under the muscle, partly under the breast tissue) is a very common method of breast augmentation. In most plastic surgery offices this term is often interchangeable with 'sub muscular' term. Very rarely is an implant truly in a purely sub muscular plane only.
The benefit of this approach, as mentioned by the other surgeons, is that it the muscle which overlies the upper part of the implant gives a more natural slope to the breast shape, hides rippling in the upper part, and is thought to lower the risk of capsular contracture. However, on the other hand it is associated with more pain, longer recovery, and an unnatural implant movement when the pectoral muscles contract.
This technique, like the other breast augmentation techniques, has its pros and cons. Make sure you discuss them with your plastic surgeon so that you may be able to make a truly informed decision before you agree to the surgery.

Sincerely,

Martin Jugenburg, MD

The most common procedure for breast augmentation is some form of dual plane technique.  All this really means is that the muscle is partially covering the top half of the implant.  There are different variations of the dual plane which are used for different anatomical considerations.  The alternative is a subglandular placement which in the vast majority of cases leads to an unnatural "implant look."

 

Good luck.