Split Muscle vs Dual Plane? (Photo)

Question

I've breastfed 4 children and am done having children. I'm getting ready, 6 days pre-op, to have round silicone implants placed subpectoraly. I am very active, athletic, and strong. I am concerned about animation deformity. Is split muscle technique really the answer to that? Does it significantly diet from the disk plane technique in regards to animation deformity? What are the pros and cons of split muscle deformity.

Joe Gryskiewicz, MD, FACS · Answer

Hi C Momma,I suppose you will receive a lot of different answers.  See the answer two down by Dr. Rigano, as I agree also you would benefit from a dual plane.  Thanks also for your photo.  I believe you will find the references below to be helpful.  All the best, Dr. Joe

Gary Lawton, MD, FACS · Answer

The most
sophisticated approach to breast augmentation is through the armpit with a
surgical camera (transaxillary endoscopic).  Using this modern approach
the space can be crafted under direct vision, with virtually no bleeding and no
postoperative bruising.  Most importantly, the shape of the breast is
meticulously created. This is the dual plane technique.  If done properly you will not have an animation deformity.  Split muscle is the periareolar technique. If done correctly you won't get an animation deformity.  If done poorly you will.  The older methods of insertion are technologically
less advanced.

Steven Wallach, MD · Answer

A dual plane is usually the way to go when you are thin. This will allow muscle coverage of the upper pole.  Best of luck.

Tom J. Pousti, MD · Answer

Thank you for the question and picture.
There are pros and cons to the placement of breast implants in the “sub muscular” position versus the "sub glandular position”. I will try to outline some of the differences here; you may find the attached link helpful as well.
I think it is in the best interests of most patients (including you based on your picture) seeking breast augmentation surgery to have implants placed in the “dual plane” or sub muscular position. This positioning allows for more complete coverage of the breast implants leading to generally more natural feel/look of the implants in the long-term. This position will also decrease the potential for rippling and/or palpability of the implants (which may increase with time, weight loss, and/or post-pregnancy changes).
The submuscular positioning also tends to interfere with mammography less so than breast implants in the sub glandular position. The incidence of breast implant encapsulation (capsular contraction) is also decreased with implants placed in the sub muscular position.
On the other hand (as you mentioned), sub glandular breast implant positioning does not have the potential downside of “animation deformity” ( movement/ distortion of the breast implants seen with flexion of the pectoralis major muscle) they can be seen with breast implants placed in the sub muscular position. 
Best wishes for an outcome you will be pleased with.

Marcel Daniels, MD · Answer

First off, you have what appears to be pretty thin tissue so placing an implant on top of the muscle would likely be a poor choice with respect to seeing the superior pole of the implant. Therefore, from a camouflage point of view, sub-muscular placement is a must. With sub-muscular placement, there is always some degree of animation deformity no matter what approach is used. The key to minimizing the animation deformity is to dissect the muscle a bit more aggressively so less of the implant is covered by muscle. Discuss these concerns with your surgeon and if your concerns are not adequately addressed, another opinion may be in order. Hope this helps, good luck!

William C. Rigano, MD (retired) · Answer

Your tissues are thin and a dual plane will look better,stay soft longer. Muscle animation occurs with maximal pectoral contraction which happens when working out. You will have a higher chance of capsule if the implant is under the breast.

Split Muscle vs Dual Plane? (Photo)

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