Does the muscle have to be "cut" for submuscular or "dual plane" placement?

The submuscular placement does involve dissecting the pectoralis major muscle along its lower chest wall attachments up to the sternal bone, so the muscle is "cut".  Without that the muscle would push the implants superiorly and it may take a while for the implants to settle into their optimal position on the chest wall. 

Although there are variations in anatomy, the vast majority of patients undergoing sub pectoral breast augmentation, almost without exception, will need the inferior most fibers of the muscle released from their attachments to the ribs and lower sternum. That being said, the exact operation you would most benefit from can only be determined in person with a proper physical examination by a board certified plastic surgeon experienced in aesthetic breast surgery. Best of luck to you.

Most doctors who do subpectoral implant placement do release the muscle along the sternal border and inferior breast to allow the implant to round out medially. When the muscle is not released, the breast tend to look flatter medially and there is more displacement of the implants laterally with muscle contraction. With either technique, the muscle must be lifted in the middle to place the implant.

Experienced plastic surgeons will release the pectorals muscle in a limited way. Usually the lower connections are tweaked to allow the implant to sit well in the dual plane dissection. I am surprised about your question concerning the muscle technique used. If you are a competitive golfer, teens player or rower then you might consider above muscle placement.It sound like you have seen two thoughtful board certified plastic surgeons. Good luck...

It sounds like they differ in their opinion regarding the dual placement technique used. There are three listed Duplain tech Meeks each of which removes more of the lower portion of the pectoralis muscle from this insertion along the sternum and rib cage. In a patient with absolutely no ptosis and a normal insertion along the lower border of the sternum the muscle consider simply be lifted and no release is necessary. In patients with mild to moderate ptosis or a lateral attachment to the muscle a portion of the muscle must be released. In patients with a very lateral lower attachment of the muscle or type two ptosis the entire lower portion of the muscle should be released. I think it is important that you should discuss with your surgeon. Ptosis and Breast fill as well as implant choices can make a huge difference in your ultimate result. 

When placing an implant in the submuscular plane, it is necessary to cut the muscle along the inferomedial attachments so that the implant sits appropriately in the pocket.

I do the same as the first doctor. Unless you cut the muscle, the lower pole does not fill out properly and look normal. It looks flat. You will never know the difference from a muscle function perspective. Good luck. 

Most board-certified plastic surgeons use the term 'dual plane' to describe a technique where the implant is partially covered by muscle (pectoralis major) and partially covered by breast tissue.  Technically speaking, the inferior (lower) attachments of the muscle needs to be divided for this to occur.  The term 'submuscular' describes a technique where these attachments are not divided.  It becomes confusing because many legitimate surgeons say 'submuscular' when they are in fact describing a 'dual plane' procedure.  Currently, it seems that most surgeons offer a dual plane rather than a true submuscular procedure.  That said, neither is universally 'right' or 'wrong.'The correct surgical plan depends on the surgeon and his/her skill set, the patient's desires, and the patient's anatomy/physical examination findings.

Thank you for the question.
It is extremely common to receive different opinions from different plastic surgeons about the best way to treat a specific “problem”. Each plastic surgeon may have his/her opinion that is based on their specific/unique education, experience, and personal preferences. Their opinions may also be shaped by unfavorable results they have encountered in their practices.
Although these different opinions can be confusing and a source of anxiety for patients, it is good for patients to understand the different options available. Ultimately, it will be up to each patient to do their due diligence in the selection of their plastic surgeon. Part of this selection process will involve the patients becoming comfortable with the plastic surgeon's experience level and abilities to achieve their goals as safely and complication free as possible. Best wishes.