Dual plane or complete submuscular implant placement?

Question

I am considering BA, and a surgeon propos ed to go Dual plane. Since the technique invoves muscle cutting my two questions are: 1. Will the muscle lose its primary working capacity. 2. Will i be able to fell implant draging/ moving on ribcag whenewer pec muscle is used (i cannot see when is the time a human does not use pec muscle). I see surgeons oftentimes write this sensation off as normal, which i and many women find unatural and distressing.

Daniel Barrett, MD · Answer

Dear Diligent327739,
I almost always place implants submuscular. It lowers the rate of capsular contracture significantly. In addition, it looks much more natural because the muscle provides covering over the implant so its not as round on the top. I've also noticed the implants drop less over time when they are protected under the muscle.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Adam Bauermeister, MD · Answer

Hello, 
The dual plane technique for breast augmentation is commonly used by surgeons throughout the United States, more so than the complete submuscular pocket position. The technique has a number of pros vs. that of complete submuscular implant which includes decrease animation deformity (moving of implant with contracture of the pectoralis muscle), expansion of the lower breast pole, and minor to mild lift of the nipple areolar complex. Only the lower attachments of the pectoralis are divided and most of the sternal attachments remain intact and allow for pectoralis muscle function. I have not had any of my patients remark about abnormal sensations of implant movement with the biplanar technique. I hope this helps. 
Best regards, Adam Bauermeister, MD

Connie Hiers, MD, FACS · Answer

In most women, implants placed under the muscle does not give any long term weakness in the pectoralis muscles.  for my patients, I do minimal cutting in the lower lateral aspect where the muscle attaches, but the muscle still remains attached.  Placing the implants behind the muscle will cause pushing the implant laterally and flattening the implant when the muscle is flexed.  If both of those issues bother you, then go for the dual plane or above the muscle approach.

Dual plane or complete submuscular implant placement?

Answers (3)

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