Dual plane or subglandular implants to avoid a lift? (Photos)

I have dreamed of bigger breasts since i can remember. I really want to avoid a lift. I love natural big breasts. In your opinion can I avoid a lift with subglandular or "dual plane"? I am looking to fo from a small b cup to a d- dd cup.. Thinking 450 ccs. I dont mind some sag A.D. i feel thats natural.. Just want to avoid the " snoopy effect". Advice?? Thank you for your time!!

Doctor Answers 22

Dual plane

Yes, I think an augmentation with implants using the dual plane technique could be sufficient to help you reach your goal. Good luck!


Middletown Plastic Surgeon
5.0 out of 5 stars 2 reviews

Dr Kayser

Thank you for your question. You should likely do well with a dual plane breast implant. This involves a partial under the muscle and under the skin approach. The implant size will of course, stretch your skin, which will lead to a higher chance of having visible and palpable irregularities especially on the lower half of the breast which would not be covered by muscle. Should you choose to place the implant above the muscle, this will lead to more visible irregularities but eliminate the likelihood of having muscle animation deformity. The ability to place fat grafts, in addition to the implant, will help to decrease visible irregularities and also improve fullness to the upper and inner portion of the breast as well. Please see the link to the video to further explain exactly what this is about. I hope this helps and have a wonderful day. Dr. Kayser - Detroit

Melek Kayser, MD
Detroit Plastic Surgeon
4.9 out of 5 stars 31 reviews

Dual plane or sub glandular 450 mL breast implants hoping to avoid a lift?

It sounds like your expectations are fairly realistic and I think the surgery can be done without an uplift if that is your preference.  The one thing I would emphasize to you is that you will need to expect widening of your areolae under the tension and weight of your implants.  A periareolar or Benelli lift will slightly raise your nipple position and narrow the diameter of your areolae when combined with a partial subpectoral breast augmentation (or dual plane) which I think you should consider.  Meet with an ABPS board-certified plastic surgeon to review options based on a face-to-face examination and please enjoy the video link above for more information.  Good luck and best wishes,

Jon A Perlman M.D., FACS
Diplomate, American Board of Plastic Surgery
Member, American Society for Aesthetic Plastic Surgery (ASAPS)
ABC-TV Extreme Makeover Surgeon
Beverly Hills, California

Jon A. Perlman, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 30 reviews

Breast augmentation

Hello and thank you for your question. You are a good candidate for a dual plane approach and can likely avoid a formal lift, if you are okay with some sagging after surgery.  The size, profile, and shape of the implant is based on your desired breast size/shape, your chest wall measurements, and soft tissue quality.  This decision should be based on a detailed discussion with equal input from both you and your surgeon.  This entire surgery can be performed with a small incision technique.  Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.   The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Richard G. Reish, MD
New York Plastic Surgeon
5.0 out of 5 stars 80 reviews

Implants to Avoid a Lift?

Patient concerns regarding the appearance of their breasts can typically be divided in two pools: volume, ptosis (droop). The procedures to address these issues are as different as the issues themselves. However, these concerns are not mutually exclusive. Many patients, whether they are aware or not, will benefit from both.

You must first consider the position of the NAC (nipple areolar complex i.e. the pigmented portion of the breast) as it relates to the inframammary crease. If the nipples are at or below the level of the crease the patient may benefit from a lift or mastopexy. The breast lift is designed to elevate sagging breasts to a more youthful position. It also helps to reshape and tighten the skin of the breasts. This is typically accomplished via a periareolar (around the nipple) incision with or without a vertical incision.

Mastopexy is an effective way to address sagging breast, however, the changes which accompany weight loss or pregnancy can also decrease volume of the breasts. When a woman wants the volume restored, or increased, a breast augmentation will also be needed in conjunction with mastopexy. Augmentation can help restore the volume loss which is well known to women following children. There are a number of options available to women considering augmentation ranging from size and implant type to access incision.   

A breast augmentation alone may also be appropriate if ptosis is mild. If the patient is comfortable with the natural appearance of the breasts (i.e. willing to accept some persistent droop) but desires them to be larger, a breast augmentation alone is the right procedure.  Augmenting significantly ptotic or sagging breasts tends to magnify the problem. In these cases, a mastopexy performed in conjunction with an augmentation is preferred.

There is a procedure for every problem. If you need a lift, augmentation alone will not address the problem. However, the question of the necessity for a lift is based upon both exam and patient expectations. Solely, based upon your photos you appear to have mild ptosis. Augmentation alone may be adequate as long as you are willing to accept some residual droop post operatively (as the augmentation alone will give you volume but will not provide a reliable/quantifiable lift). In spite of this I believe your optimum result will be obtained via augmentation/pexy. 

Patients are encouraged to discuss their concerns with their physicians in order to make an educated decision (as their are numerous things to discuss in this particular case). In order to determine which technique is right for you, consult with a board certified plastic surgeon.

Donovan Rosas, MD
Westchester Plastic Surgeon
5.0 out of 5 stars 7 reviews

Dual plane or subglandular implants to avoid a lift?

While some surgeons like subglandular implants, I believe that they aren't the best choice for thin patients with little breast tissue. There are too many issues with palpability, wrinkling, and an increased risk of capsular contracture with subglandular implants. Also, you are more likely to develop more sagging especially if you try to use large implants in hopes of taking up more of the loose skin-it just doesn't work long term.

If you are dead set against a lift, go ahead and have a subpectoral dual plane augmentation. Once your breast shape has settled after 3 to 4 months, you can decide whether or not you like the shape, then proceed with a lift if necessary. 

Subglandular or Dual-plane to avoid a lift?

If you are comfortable with some breast laxity and mild ptosis (lower breast position) then either a subglandular implant placement or dual-plane placement (partially under the pectoralis muscle) should work. The level of the nipple should be at a position level with a point halfway between the elbow and shoulder, and your nipple level looks appropriate. Due to the lack of fullness in the upper breast in most women after pregnancy or weight loss I often recommend the dual-plane position, as this will help cover the upper part of the implant even if the implant position is a little lower. Also remember that a lift in the future is always an option, if you choose.

Douglas Leppink, MD
Grand Rapids Plastic Surgeon
5.0 out of 5 stars 23 reviews

Want to avoid a lift. I love natural big breasts.

The location of the pocket can depend on the size of the implant, and the amount of natural breast tissue to cover the implant. The implant size should be full enough to fill out the skin envelope, and the nipple is best just at or above the breast fold to have a good breast shape without a lift. Based on a photo alone augmentation in a submuscular position as a first step should work out well.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.1 out of 5 stars 40 reviews

Lift?

Nothing avoids a lift. Placing implants usually just adds volume and does not lift the breasts to any great extent. If you need a lift then you need a lift. Best of luck.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Dual plane or subglandular implants to avoid a lift?

We get this question a lot as many women share your basic look. An experienced surgeon should have no trouble helping you meet your goal without a lift. Some surgeons feel subglandular placement is a good idea, the great majority of surgeons would disagree with that for most patients. If you are very thin in the upper part of the chest, there is a significant chance you will see the edges of the implant, the "fake look", and although that is actually the goal for some women, most patients are trying to avoid that. The dual plane implant placement leaves the thick muscle to hide the upper implant edge but in the lower half of the breast the implant is not under the muscle, thus that area is full and round, thus the natural look.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 24 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.