Can you explain the details behind the different levels of Dual Plane method in breast augmentation? (Photo)

Dear kvo,    Thanks for submitting the before and after  pictures . Are you breasts similar and are the after pictures your goal?  The different levels of dual plane breasts augmention that you mention, are not a univesal classification. I , for one , never used it in 27 years of practice. Basically, a dual plane means creation of the implant's pocket partially under the muscle ( upper pocket ) and partially under the skin ( lower pocket ) . At  times , just breast augmentation will give you the result that you presents ( very strechable skin ) and at times a mini lift or even full lift is necrssary. That can be determind only on physical exam by an experience plastic surgeon. I would argue against lowering the inframammary fold as much as was done in your after picture, because the skin is quite thin at that level and the implants will be palpable. A better option will be augmentation with less lowering of the IMF followed by mini lift ( donut ) which will keep the breasts in higher position and with less palpable implants at the lower pole. Always, consult with experienced board certified plastic surgeons who operate in accredited surgery center for your safety. Most importantly, check their before and after pictures to make sure that they are numerous, consistent and attractive. Check also the 'realself' reviews for positive patients experience which provides important information on the surgeons.                     Best of luck,                                       Dr Widder

My best suggestion is to pick the best plastic surgeon rather than the procedure. It is their job to guide you through this process. See below link on how to select the best plastic surgeon for the job.Here is some general information however on the dual plane technique. For cosmetic Breast Augmentation, the dual plane technique refers to the implant being partially beneath the pectoralis muscle. As the lower part of this muscle is above the lower lateral part of the breast most Subpectoral implants are in fact to a degree dual plane although erroneously often called total submuscular. However, the degree of the implant is beneath the muscle on top and soft breast tissue below can be altered by making the submuscular pocket higher up the muscle leaving some of it below the implant below and some above. The advantage of this is to expand the lower pole of the breast if short or more often for mild drooping breast correction. A grading system has been suggested and published that you are referring to but my impression is that most plastic surgeon's do not refer or use it at this time. 

Without your photos- it's impossible to assess your case. Generally speaking- implant placement can be completely under the muscle, or completely over the muscle. Often times, it can be partially under the muscle and partially not under the muscle. This is best left to the operating surgeon with the goal in mind to create the most attractive breasts.

Great Question. We use the Dual Plane technique on patients from around the country who are seeking improvement in their nipple position (like a breast lift) without the scars of a breast lift using just the implant. This is achieved by separating the pectoralis muscle from the overlying breast tissue. This allows the breast to move relative to the muscle. When the implant is placed under the muscle this forces the nipple up. it is like if you stand behind a curtain and then walk forward, the bottom of the curtain will lift up off the ground. The difference in the DUAL PLANE 1, 2 and 3 is how much separation is created to increase the amount of lift to fit your unique anatomy.

This is a great question. It shows that you are really doing your homework.When a patient presents with a small amount of breast ptosis (sag) a dual plane breast augmentation is a very effective technique to help avoid the need for a breast lift and still allow the implant to be placed under the muscle. When an implant is placed under the muscle and the overlying breast has some degree of sag the muscle will hold the implant back and not allow it to fill the loose tissue at the bottom of the breast The word dual means two and the word plane refers to the natural separation between two layers of tissue. In the breast there is a natural separation between the breast tissue and the underlying muscle. During a dual plane augmentation the breast tissue in the lower part of the breast is separated from the underlying muscle. The muscle is then released along its entire attachment at the bottom of the breast. The muscle then moves upward like a window shade toward the nipple. The different levels of the dual plane method refer to the amount and extent of release of the breast tissue from the underlying muscle. For instance release of the lower one inch of breast tissue from the underlying muscle will give some degree of llift. If the release extends to or above the nipple a greater amount of lift is achieved. The level of dual plane augmentation needs to be individualized for each individual patient. With the restriction of the muscle in the lower part of the breast removed the implant is then allowed to fill the loose sagging part of the lower breast. This is a very effective technique to help prevent the need for a breast lift in a patient with a small amount of sag and still have a benefits of an implant placed under the muscle. This technique is also very helpful in the treatment of other conditions with constriction in the lower part of the breast.