What is the difference between dual plane and under muscle placement of breast implants?

Dual plane placement of breast implants means that the upper inner portion of an implant is partly under the chest muscle and the lower outer portion is under the breast tissue. This approach gives a very natural appearance to breast enhancement.Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author

The Dual Plane technique involves release the breast tissue on top of the muscle so that the breast tissue can be centered over a submuscular implant.  This is useful in patients with mild to moderate ptosis.

In dual plane breast augmentation, the implant is placed partially beneath the pectoral muscle and partially beneath the breast tissue. This technique combines aspects of both subglandular (above the muscle) and submuscular (under the muscle) placement. Under the muscle placement, also known as submuscular, involves positioning the implant beneath the chest muscle. This can provide additional coverage for the implant, reducing the risk of visible rippling and creating a more natural appearance.The choice between dual plane and under muscle placement depends on factors such as the patient’s anatomy, the type of implant, and the desired outcome. Surgeons consider these factors to determine the most suitable technique for each individual case.

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. 

These are surgical terms related to various classifications. It is uncommon in aesthetic practice for an implant to be completely covered by muscle. In fact in the lower portion of the chest wall the muscles are virtually non existent and the actual cover in this region is a very thin fascia and so in my opinion complete muscle cover is impossible. In Dual plane the implants are placed under the muscle in the upper portion where the muscle exists and above the chest wall and under the breast (sub glandular) in the lower portion. 

Dual plane breast augmentation is a description of releasing the breast tissue off the muscle so that it redrapes over the implant that is placed under the muscle. It is not separate from under the muscle placement it is just a technique used to improve soft tissue coverage of the implant. The technique separate from under the muscle is subglandular or over the muscle which does not release the muscle at all and the implant is placed under the breast gland itself. Hope this was helpful. 

Except in reconstruction, an implant placed under the muscle it is known as dual plane because, the implant is not completely covered by the muscle. Dual plane is the correct way of saying it, but is easier to say under the muscle so the patients will understand. best of luck, 

Hi Booblessbecky,Dual plane is under the muscle placement of the implants. There are some nuances on how you make the pocket for the implant whether it be above the muscle (subglandular or subfascial) or below the muscle (dual plane type I,II or III) but I would not worry about these aspects too much.The main question is whether you have the implants above or below the muscle and there are pros and cons of each.  If one way was the best, the other way wouldn't exist.Under the muscle gives the implant better cover and so is particularly useful if you are slim, but the pull of the muscle can cause problems.  Over the muscle is good because the implant sits with the breast, but you may be more likely to see or feel the implant if you don't have much soft tissue cover over your chest.This is something that would be discussed at your consultation, so be sure to go armed with questions to help you make a balanced decision about what might be right for you.Good luck.

Thank you for the question.  Semantics can be confusing.Dual plane breast augmentation refers to breast implant positioning in the sub muscular ( pectoralis major)  positioned superiorly and the sub glandular position inferiorly.  This is the breast implant position used by the majority of plastic surgeons today and what I would suggest for the vast majority of my patients.
I think it is in the best interest most patients seeking breast augmentation surgery) to have implants placed in the “dual plane” 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 in the sub glandular position. The incidence of breast implant encapsulation (capsular  contraction)  is also decreased with implants placed in the sub muscular position.   However, the sub muscular (dual plane) breast implant positioning does have the potential downside of “animation deformity” ( movement/ distortion of the breast implants  seen with flexion of the  pectoralis major muscle).
 Again, I think the advantages of sub muscular (dual plane) breast implant placement far outweigh the  potential disadvantages associated with breast implants  placements of glandular position,  no matter how active the patient.
I hope this helps.

A dual  plane breast augmentation is essentially a submuscular augmentation with the added release of the breast off of the underlying muscle.  This allows the breast gland to properly redrape over the new mound created by the implant underneath the muscle.  Today the dual plane method is the preferred method for submuscular breast augmentation and breast augmentation in general.