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

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.