Torn between Subfascial and Dual-Plane BA. Which should I choose? (photo)

There are pros and cons to subfacial and dual plane pockets for breast augmentation. Because of your lack of breast tissue and fat, subfascial pockets will potentially increase your risk for rippling. However, there is generally less postoperative discomfort during your recovery after surgery. With a classic dual plane pocket the muscle is cut. As a result, you can lose strength in your chest muscles after surgery. There tends to be more pain right after surgery. There is also a potential for animation deformity of the breasts when flexing your chest muscles. On the plus side there is less potential for rippling. I use a technique called a dual plane split muscle pocket where the muscle is separated between the muscle fibers rather than cutting the muscle off of the lower ribs. This technique preserves the continuity of the muscle, which preserves your muscle strength and reduces the chance of rippling and animation deformity.No pocket is better than another at reducing the chance of breast ptosis or sagging over time. Thank you for sharing your photos and questions. Best wishes.Dr. Gregory Park

Hello,You should know that the concept of 'subfascial' is more theoretical than substantial in its difference from subglandular.  It is really no different anatomically from subglandular, and the fascia, even if was important to make a difference from subglandular, is unlikely going to remain intact as a definitive layer after placement of the implants.  Most importantly, it does not enjoy the lowest risk of capsular contracture or tissue coverage as subpectoral placement.You worry about how your Crossfit will be affected, but forget that your risk of reoperation is higher with implants placed over the muscle. You will not always be doing Crossfit, but you'll likely have implants for the rest of your life.Just as an aside, the same decision making process should be applied to your incisions.  Periareolar incisions carry the highest risk of capsular contracture, and inframammary the lowest.  In Southern California, there is a unique trend to place implants through the periareolar incision despite the evidence of worse outcome. Best of luck!

As you know, there are advantages and disadvantages to both types of implant placement. Really, the final decision is going to be up to you. Only you can decide what's right for your lifestyle. Best, Dr. Nazarian