I know what dual plane is, but I need to understand the stages 1, 2, 3,etc. help?

If  you trust your surgeon, you don't really need to be splitting hairs, as he will do what is best.What you are concerned about is where the muscle is transected, whether it is at the fold or a little higher. For inferior ptosis he will want to release the muscle to allow the skin envelope to be filled out by the implant.Good luck,Greg Sexton, M.D.Columbia, S.C.

Your question is a good one but the degree of dual planing is a subjective decision by your plastic surgeon during surgery depending on how much ptosis you have and how much separation is desirable between the pectoral muscle and your breast tissue. At the risk of sounding arrogant or patronizing, as a patient you should not concern yourself about the technical specifics of your surgery, but trust your plastic surgeon. Hopefully your result will meet your expectations. Best of luck to you.

While I routinely use a dual plane fro breast augmentation ,  most of the time I do little to know release of the gland from the muscle.  If a patient needs a lift, I find that a circumareola or vertical may be  a better option.

The dual plane technique for breast augmentation is certainly a difficult thing to find reliable information about on the internet.  You are correct in that there are three types of dual plane dissections. The types are based on the area over which the breast tissue is separated from the muscle.  In a type 1, there is no dissection between the breast tissue and muscle.  In a type 2, the surgeon separates the breast tissue from the muscle in the area spanning from the lowest extent of the muscle to the level of the BOTTOM of the areola.  In type 3, the separation is carried out even a little further such that it extends from the lower aspect of the pectoralis to the the level of the UPPER border of the areola.  So, what does all that mean and why does it matter?  Fair questions!  In all types of dual plane, the implant is going to be placed under the pectoralis muscle (subpectoral).  In truth, the top portion of the implant will be covered by muscle.  The bottom of the implant will just be covered by breast tissue.  But, the point is that it sits in the same position regardless of the type of dual plane performed.  What matters when thinking about the different dual plane techniques is thus not the location of the implant but rather how the breast tissue and muscle are oriented over the implant and to what extent the muscle will be allowed to retract upward.  The decision of technique is based on your tissues and anatomy.  A dual plane 1 is typically for breasts with no ptosis (sagging) and strong attachment between the breast tissue and the muscle.  A dual plane 2 is employed when there may be slightly more ptosis and looser attachments between the breast and muscle.  And, finally, dual plane 3 is used when there is true ptosis and loose attachments.  This will allow the muscle to glide up the most and allow maximal contact between your breast tissue and the implant.  In doing so, this will help improve some degree of ptosis and avoid deformities that could result if the dissection between the breast and muscle was not performed.  In the end, from your description of your breasts, this is probably what your surgeon is trying to accomplish for you. As you can see, this is all on a continuum.  In the end, the preoperative and intraoperative judgement of your surgeon is of paramount importance and will decide your result much more than the definitions of dual plane types. But I completely understand your desire to be as informed as possible, so I hope that this answer has helped in that regard.  I have provided a reference that, though a bit technical, may help answer your question even further.  I wish you the very best.