Does the muscle need to be cut when doing a Dual Plane Breast Augmentation and Areola nipple incision?

Dual plane means the muscle is cut, to allow it to retract a little.  As to the areola approach, if your surgeon feels he is able to do it through the areola then that's fine.  For others who have more experience with the inframammary approach, your areolas may look small.  

By definition a dual plane augment requires the muscle to be released from the chest wall, so yes it does require a muscle incision. In general an inframmary incision is better hidden in most cases and associated with a lower incidence of capsular contracture and may cause less issues with breastfeeding which is why I generally don't even offer a periareolar approach to my patients. If they really want that incision then we will have a long talk about the risks (several) and benefits (nearly none in my opinion) before I agree to do it. Hope that helps!

Using a dual plane approach does require that the muscle is cut to allow for the implant to settle in the lower pole. This gives the breast more natural shape. Using an areolar incision in my opinion is is more difficult with silicone implant versus saline implants. This approach also increases the rate of capsular contracture and can potentially decrease nipple sensation.

The pectoralis major muscle does need to be cut to perform a dual plane breast augmentation. This is necessary anytime the implant is placed under the muscle.The periareolar approach is more challenging with a small areola.  Not only is it more difficult to visualize the dissection, but it is also harder to place silicone implants. Generally speaking, the larger the implant the more difficult it is to get through a small incision. Your plastic surgeon will be the best person to determine whether or not the periareolar approach will best meet your goals.  Keep in mind that surgeon preference may also play a role in these recommendations.

Your muscle would need to be cut in order to place them under the muscle. A well developed pectorals muscle should not affect this but a dual plane will minimize the possibility of the muscle displacing the implant too high on the chest. This can be done through either an infra-mammary incision or periareolar incision. Typically you need a 4-5cm incision under or above the areola so measuring the outer edge of the areola can let you know if you have enough room. There is a slightly higher risk of capsular contracture going through the areola according to some studies but I still will perform this if the patient is requesting it. Good luck

When
you refer to a dual plane breast augmentation, I am assuming that that is a
submuscular placement. Therefore, the
breast implant is partially under the muscle.
During a submuscular breast augmentation, the muscle does need to be
released from the sternum and the inferior attachments. So, yes, the muscle is actually cut. A periareolar incision is a very common
approach to breast augmentation.
However, if you desire a very large implant and your nipple-areola
complex is very small, it might be difficult to get a large silicone implant in
through that incision. In that case, the
approach needs to be in the inframammary position (under the breast).

In order to allow the implant to sit next to the breast bone, a plastic surgeon will typically divide the fibers of the pectoral major muscle that arise from the ribs and sometimes those along the lower breast bone. The vast majority of the muscle remains intact, so the function is not impacted.If you have small areolas, it may be difficult to insert silicone gel implants through the areola, particularly if the implants are large or textured. A Keller funnel facilitates insertion through a smaller areola, but if the areolas are truly small, even the Keller funnel won't get a silicone gel implant where it needs to be without an extension of the incision beyond the areola. Click on the link below to see how a Keller funnel is used.Complications include a slightly higher capsular contracture rate; a risk that the scar could become tethered to the muscle, resulting in distortion of the breast with movement of the muscle; and a slight increase in the risk of inability to breast feed compared with the fold approach. Good luck with your decision.

Yes, the pectorals muscle along its insertion into the inferomedial chest needs to be divided in order for the implant to sit correctly.

“Official” recommendations would necessitate an in person evaluation but some general thoughts may be helpful to you. I think that it is  in most patients best interest to undergo breast augmentation surgery in the sub muscular (dual plane)  position. I have found  no additional difficulties performing this operation on patients with “well-developed” pectoralis major muscles, including accomplished bodybuilders and transgender patients (both of these subsets of patients tend to have very well-developed pectoralis major muscles).  In the long-term, patients do have full strength and use of the pectoralis major muscle. The downside associated with the  submuscular breast implant positioning is the potential for animation or flexion deformity ( breast implant movement with contraction of the pectoralis major muscle).In my practice, the majority of breast augmentations are performed through infra areolar incisions;  it is a very rare patient whose areola are too small to allow for this approach. The use of the Keller  funnel has been helpful in this regard.You are wise in doing your due diligence; select your plastic surgeon carefully and communicate your goals carefully as well. Best wishes.

As the other consultants have said a portion of the insertion of the pec major is cut in order to create the dual plane and with the use of the Keller funnel almost any sized implant can be placed via an areola incisionDr Corbin