Most plastic surgeons that have a large practice with a diverse experience in cosmetic breast surgery, i.e., breast augmentation,breast lift, breast augmentation with simultaneous breast lift, and breast reduction, are well trained in dual plane surgery of the breast.
The term "Dual Plane" is much newer than the actual techniques, and was recently "coined", but truly, most plastic surgeons are quite familiar and practice this technique. When patients ask me this question, I reassure them not only that I am familiar with, trained and practice the "dual plane" technique, but I also educate the patient in the different choices for implant placement and pocket dissection-emphasizing that the choice for "dual plane," submammary (on top of the pectoral muscle) or subpectoral (under the pectoral muscle) will be something I consider for each patient, based on their anatomy. Implants that are "subpectoral" are in fact, only partially covered by "muscle" as the pectoral muscle does not have the same shape, position, as the breast overlying it.
Therefore, any implant of any size or shape, placed "subpectoral" is covered by not only the pectoral muscle, but also be the breast and this is where the modern day term of "dual plane" was created, but in truth, the technique is "old". "Dual plane" is a term to recreate something that most experienced plastic surgeons have been doing for decades. All subpectoral implants are truly both under the pectoral muscle in the inner portion and upper portions of the breast where the muscle is anatomically present--and--- truly under the breast (submammary) in the outer and lower portions of the breast where there is no pectoral muscle.
I like to draw this anatomy for the patient so they understand exactly where the implant will be in relation to the muscle and breast and this will help explain what they see and feel following the breast surgery, so there is less room for confusion or mystery. I do all techniques and base my decision on what I hear as I listen to the patient, but most importantly, on what I obtain from my assessment of the patient's anatomy by physical examination and photography of the breast and chest in several postitions that help me to see as much as I can of the 3 dimentional aspect of the anatomy.
The operation is then customized to the patient's unique anatome to give the best result. The anatomy can be very different from one breast to the other in the same patient and certainly from one patient to another patient, so I warn patients to not rely too much on the "friends" opinions or experiences as everyone is unique!