Dual Plane Same As over Muscle?

i wondered if you could kindly confirm, is the dual plane method another term for over the muscle method? I'm confused and always thought they were two totally different techniques but from what I'm reading in now wondering if in fact they are the same?

Doctor Answers 14

Dual plane same as over the muscle?

Good question. A dual plane breast augmentation results with the top portion of the implant covered by muscle and the lower part of the breast covered by breast tissue.When a patient presents with a small amount of breast ptosis (sag) a dual plane breast augmentation is a very effective technique to help avoid the need for a breast lift and still allow the implant to be placed under the muscle. When an implant is placed under the muscle and the overlying breast has some degree of sag the muscle will hold the implant back and not allow it to fill the loose tissue at the bottom of the breast The word dual means two and the word plane refers to the natural separation between two layers of tissue. In the breast there is a natural separation between the breast tissue and the underlying muscle. During a dual plane augmentation the breast tissue in the lower part of the breast is separated from the underlying muscle. The muscle is then released along its entire attachment at the bottom of the breast. The muscle then moves upward like a window shade toward the nipple. With the restriction of the muscle in the lower part of the breast removed the implant is then allowed to fill the loose sagging part of the lower breast. This is a very effective technique to help prevent the need for a breast lift in a patient with a small amount of sag and still have a benefits of an implant placed under the muscle. This technique is also very helpful in the treatment of other conditions with constriction in the lower part of the breast.

Omaha Plastic Surgeon
4.8 out of 5 stars 112 reviews

Subglandular vs Dual Plane explained

Subglandular means beneath the Breast tissue but above the pectoralis muscle.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.

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 154 reviews

Dual Plane in Breast Implant Surgery

The Dual Plane technique places an implant partially beneath the Pectoralis muscle (submuscular) but allows the lower part of the implant to lie only beneath the breast tissue (subglandular). So the implant is really in a combination of positions. Depending on how much sagging there is in the breast, will determine how much of the implant is allowed to be covered by the implant vs allowing it to be more just beneath the breast tissue. I use this technique most of the time. it is flexible and allows for variation between patients. It combines most of the benefits of both submuscular and subglandular.

Ronald Schuster, MD
Baltimore Plastic Surgeon
4.9 out of 5 stars 77 reviews

Dual Plane Technique

"Dual Plane" technique is a marketing term for under the muscle. One of the only times an implant may be placed completely under the muscle is in a breast reconstruction and that is certainly no where near 100%. 

Robert Kearney, MD, FACS
La Jolla Plastic Surgeon
5.0 out of 5 stars 32 reviews

Dual Plane Terminology

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.


Warmest Regards,

Asif Pirani, MD, FRCS(C)

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

What does Dual Plane breast augmentation mean?

Dear Biddy

Dual Plane is the name of the modern technique of submuscular (under the muscle) breast augmentation. It involves the top part of the implant being put under the muscle, with the lower part of the implant being under the breast gland itself. In dual plane breast augmentation, the muscle is freed up from various attachments as well as from the breast gland, with the purpose of allowing the breast to redrape over the muscle and implant in the most natural way possible.

It is an excellent technique in certain circumstances, however subglandular breast augmentation (on top of the muscle) is also still widely used (again, for the right situation).

I hope this clarifies things for you!


Marc Pacifico, MD, FRCS(Plast)
London Plastic Surgeon
5.0 out of 5 stars 47 reviews

Dual plane

Subglandular is on top of the muscle, total muscular coverage is completely under, and dual plane is a hybrid.

Michael Hueneke, MD
Nashville Plastic Surgeon
4.9 out of 5 stars 63 reviews

Dual Plane is Different than Over the Muscle

This is a common question and can be confusing since breast augmentation is the most common cosmetic surgery performed in the US.  Dual plane is when the implant is placed under the muscle and has about 10-15 percent portion of the inferior part of the implant with breast gland coverage only.  This is a nice look because it is natural.  Submuscular usually means complete coverage of the implant with the pectoralis muscle.  Subglandular means the implants are completely on top of the muscle and have only breast gland covering them.  I hope this helps! Tripti Burt, MD

Tripti Burt, MD
Plainfield Plastic Surgeon
4.8 out of 5 stars 57 reviews

Are Dual Plane and Submuscular the Same?

Thank you for your question. In a dual plane augmentation the surgeon will release the muscle (Pectoralis) from its' insertion into the ribs and also release the breast tissue from the Pectoralis muscle. The extent of breast tissue released from the muscle is typically dictated by the results the surgeon is trying to achieve.

A dual plane augmentation will commonly be used  to correct breasts with tissue that is very mobile, have glandular ptosis (drooping), and also for breasts with a constriction in its' bottom half (lower pole) as is seen in patients with tuberous breasts.

I hope this helps.

Pedro M. Soler, Jr., MD
Tampa Plastic Surgeon
4.9 out of 5 stars 39 reviews

Dual plane breast augmentation

No, dual plane and over the muscle is not the same.  In a dual plane procedure, a portion of the implant is under the muscle.  The superior half of the implant is covered by muscle and the bottom half is under the breast tissue.  The amount of implant covered by the muscle can be controlled based on how much of the muscle is released as well as how much the breast is separated from the muscle.  This allows for more precision in placement of the implant than just the traditional submuscular placement.

Naveen Setty, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 74 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.