Dual Plane Approach for Breast Implant Reduction?

I'm having my High Profile submuscular breast implants reduced to either MP Plus or MP. The plastic surgeon will perform dual plane approach this time. Is it ok to have this switch?

Doctor Answers 7

Nothing magic in "dual plane"

The standard submuscular augemntation performed by most surgeons is "dual plane" because the pec major cannot cover the implant in the lower outer corner of the breast. This isn't new, novel, or better just because some now use the fancy term "dual plane." If you are already submuscular, you are already dual plane. If you are subglandular, doing a submuscular conversion will make you dual plane.

If your pocket isn't a problem, downsizing implants should just be done in the same pocket you already have. The real problem you face is not the pocket but whether you will need lifting because of loose skin after downsizing.

Seattle Plastic Surgeon
4.8 out of 5 stars 67 reviews

Not a reduction technique



As has been noted by other plastic surgeons answering, the dual plane technique will not make the pocket smaller for down-sizing implants regardless of profile. I would return to your plastic surgeon and ask them to explain to you what they meant and how it will help your outcome.

Dr Edwards

Michael C. Edwards, MD, FACS
Las Vegas Plastic Surgeon
5.0 out of 5 stars 35 reviews

Dual plane helpful in re-draping your breast over a new implant

I have used what is now called a dual plane approach for over 25 years. Essentialy, the doctor is detaching the breast gland from the muscle, placing the implant under the muscle, and then re-draping the breast gland and skin over the new mound created by the breast implant and overlying muscle.

The benefit of this maneuver, especially if the breast is ptotic or droopy, is that the breast gland and skin can be draped over the newly created breast mound created by the new submuscular implant, and the nipple areolar complex elevated to a more youthful position.

Since you have had previous submuscular breast implants, the muscle will have been stretched and be thin. This can make it very difficult technically to develope the subglandular breast plane. This challenge however is for your surgeon to handle.

See before and after photos of breast augmentation.

Don't get caught in terminology.

Dual-plane, over-under, and many terms you hear are purely marketing terms designed to make it look like your doctor is giving you something special. Most submuscular implants are placed so that not the entire implant is covered by muscle. The part that is not covered is part of the "dual plane" or the "over" in the over-under terminology.

Maybe your implants were placed completely submuscularly the first time. If you are having concerns about the profile, it could be simply that the complete submuscular placement is making them look more unnatural.

In either case, having a dual plane now sounds like the right way to go. Make sure you cover diameters and sizes carefully before making changes. Best of luck.

Francisco Canales, MD
Santa Rosa Plastic Surgeon
5.0 out of 5 stars 35 reviews

Be clear on terminology

Dual-plane and submuscular are really pretty much the same thing. The term "dual plane" refers to the fact that the pectoral muscle doesn't cover the lower portion of the implant, so that part is subglandular. A few surgeons do what is called total submuscular, which involves lifting other muscles to try to get coverage there, but this is uncommon so most people are doing dual-plane and calling it submuscular.

Another option is a split muscle approach, in which only the upper portion of the muscle is in front of the implant. This is useful when there are animation deformities, that is the breast changing shape or moving when the pectoral muscle is flexed. The split muscle approach prevents animation problems while still proving muscle coverage on the upper part where it is most important.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 52 reviews

What do you mean exactly?

What is your understanding of this operation, what are your goals, and what is it that you are trying to correct (i.e., what don't you like right now), and when did you have your last operation.  Finally, why dual plane?


Scott E. Kasden, MD, FACS
Dallas Plastic Surgeon
4.7 out of 5 stars 101 reviews


Let me clarify some terminology that many plastic surgeons themselves misuse.

  1. Submuscular = the implant is COMPLETELY under the muscle with no release of the muscle (rarely done).
  2. Subpectoral = the implant is placed under the pectoralis major muscle, with the inferior edge of the muscle released so that the lower portion of the implant is covered by gland.  This is what most people refer to as "submuscular"; however, they are technically incorrect. A classical subpectoral placement is the same as a Dual Plane I.
  3. Dual Plane = a form of subpectoral implantation with varying degrees of muscle release/separation from the gland in order to vary the amount of muscle/gland coverage ratio.

It may be semantics, but semantics are important.  In summary, Dual Plane is a form of under the muscle or subpectoral placement.

Asif Pirani, MD, FRCS(C)
Toronto Plastic Surgeon
5.0 out of 5 stars 35 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.