What is the difference between a double plane breast augmentation and a sub-glandular breast augmentation?

Which one is best and why?

Doctor Answers 7

What is the difference between a double plane breast augmentation and a sub-glandular breast augmentation?

Thank you for the question.

You will find that the majority of plastic surgeons today place breast implants in the sub muscular  position; because the implants are partially sub muscular and partially sub glandular, the sub muscular positioning is also referred to as a dual plane position. There are pros and cons to the placement of breast implants in the “sub muscular” position versus the "sub glandular position”.    I will try to outline some of the differences here;  you may find the attached link helpful as well.

I think it is in the best interests of most patients seeking breast augmentation surgery to have implants placed in the “dual plane” or sub muscular position. This includes athletic patients.

The submuscular positioning allows for more complete coverage of the breast implants leading to generally more natural feel/look  of the implants in the long-term. This position will also decrease the potential for rippling and/or palpability  of the implants (which may increase with time, weight loss, and/or post-pregnancy changes).

The submuscular positioning  also tends to interfere with mammography less so than breast implants in the sub glandular position. The incidence of breast implant encapsulation (capsular  contraction)  is also decreased with implants placed in the sub muscular position.

On the other hand,  sub glandular breast implant positioning does not have the potential downside of “animation deformity” ( movement/ distortion of the breast implants  seen with flexion of the  pectoralis major muscle)  they can be seen with breast implants placed in these sub muscular position.  Also, the immediate recovery period may be  more comfortable  after sub glandular breast augmentation as compared to sub muscular breast augmentation surgery.
Best wishes.  

Dual plane is partially under muscle

Thanks for your question. Dual plane augmentation is a term given to partial muscle coverage of the implant. A partial dissection is made at the lower attachments of the base of the breast over the pectoralis muscle, and this drops the breast gland slightly over the lower part of the implant and off of the muscle. This often creates a more natural look, and the degree of dissection varies based on your anatomy. Most augmentations done now are placed in the partial sub muscular plane due to the benefits of a more natural look and less capsule contracture over time. 

Wesley G. Schooler, MD
Santa Barbara Plastic Surgeon
4.8 out of 5 stars 17 reviews

Breast augmentation

Sun glandular means the implant is entirely in front of the muscle.  Dual plane refers to breast implants I which the upper part is covered by the chest muscle.  This is the way the typical sub muscular  augmentation is done and I believe it is better in most cases.

Ronald J. Edelson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 25 reviews

What is the difference between a double plane breast augmentation and a subglandular breast augmentation?

    Most implants are placed in the submuscular position rather than the subglandular due to a number of benefits.  The dual plane is a variant of the submuscular approach.

Kenneth Hughes, MD

Los Angeles, CA

Dual Plane better in the right candidate

lilywater:  A subglandular augmentation is one in which the implant lies beneath the breast tissue, on top of the pectoralis muscles.  A dual plane augmentation involves creating two separate pockets, one on top of the muscle and a second beneath the muscle.  The implant is placed in the deeper pocket below the muscle.  Only a relatively small percentage of woman require the extra dissection above the muscle.  This is performed in cases where there is a small degree of breast "droopiness" but not enough to require a breast lift.  In general terms, if your plastic surgeon feels you are a candidate for the dual plane procedure this is a better option than the subglandular approach.  Implants placed beneath the muscle have a lower rate of capsular contracture, less chance of rippling and will result in a better mammogram amongst other benefits. 

Good luck to you!

G. Robert Meger, MD
Phoenix Plastic Surgeon
4.9 out of 5 stars 85 reviews

Dual Plane breast augmentation

The original operation for breast augmentation placed a silicone gel implant immediately below the breast and above the pectoralis muscle. The natural aging process of the breast is to lose volume most noticeably in the portion of the breast above the nipple. Over time this leads to visibility of the implant often seen as rippling. The incidence of capsular contracture is also seen more frequently with implants above the muscle.
Implants below the muscle have a significantly lower incidence of capsular contracture and provide added soft tissue above the nipple limiting visualization of the implant.
By placing the implants in a dual plane position, the upper half under the muscle and the lower half under the breast, we get all the benefits of more tissue above the areola and less capsular contracture. In addition to this the muscle compresses the upper pole of the implant softening the appearance of the implant and providing a more natural look to the breast. The degree of upper pole fullness can be controlled by choosing the proper profile of the implant.
I hope this was helpful

Robert W. Kessler, MD, FACS
Corona Del Mar Plastic Surgeon
4.9 out of 5 stars 122 reviews

Difference between dual plane and sub-mammary breast augmentation

A dual plane or double plane breast augmentation involves creating a breast implant pocket beneath both the breast gland and a second pocket below the muscle.  Placing the breast implant beneath the muscle is the preferred method for most patients today.

The purpose of the plane beneath the breast gland is to allow and encourage the breast gland to redrape properly into a good position over the newly created breast mound caused by the implant beneath the chest muscle.

A sub-mammary breast augmentation involves only the creation of the pocket beneath the breast gland and the implant is not placed beneath the chest muscle.

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.