What is the difference between partial sub-muscular and dual plane techniques?

Submuscular placement may be more uncomfortable the first few days following surgery. The possible benefits of submuscular placement are that it may result in less palpable implants, less capsular contracture, and it will make it easier to image the breast with mammography. The appearance may be more “natural” for patients who are very thin. Subglandular placement may make your surgery andrecovery shorter and you may have less discomfort. This placement may provide a slight “lift”. Subglandular placement may result in more palpable implants, more capsular contracture and more difficult imaging of the breast with mammography. This placement is often recommended for those patients with sagging, but do not want a breast lift (mastopexy) and for tubular breast deformity

The two techniques are the same and I use this technique quite frequently.  It will help in mild ptosis.  More importantly, it significantly reduces the movement of the implant with animation of the pectoral muscle. 

Thank you for your question. Most "subpectoral" breast augmentations are performed by either of these techniques. They are very similar. The partial sub muscular technique is when the pectorals major inferior and inferior/medial attachments are released so that the bottom half of the implants is covered by the gland and the top half is covered by the pec major muscle. As for dual plane -- this generally describes a further elevated of the gland off of the pectorals major muscle allowing the muscle to ride higher up on the implants and allowing the gland to sit on the bottom half of the implant. In the dual plane, the top aspect of the muscle will be released for a few centimeters as well above the inferior aspect of the pec. This may allow the muscle/gland to have a more aesthetic redraping over the implant.I hope this helps.- Dr. Bryson Richards

Hi and thank you for your questions.  Dual plane and partial submuscular really mean the same thing.  The difference is that dual plane is a more specific term and has 3 different variations depending on how the muscle is separated from the breast tissue.  Depending on your degree of sagging beforehand, a dual plane approach is a great option for excellent results.  Best to speak with a board certified plastic surgeon in person who can better discuss your options.  Good Luck!

These two names describe the same technique where the pectorals muscle is divided along the inframammary fold on the inside of the breast. It is not marketing so much as the scholarly article that described the partial sub muscular technique described it as dual plane.

An implant placed above the muscle is referred to as ‘sub-mammary’ (or ‘sub-glandular’), while an implant placed under the muscle is referred to as ‘sub-pectoral’ (or ‘sub-muscular’).The muscle in question is the pectoralis major.The term ‘sub-pectoral’ or ‘sub-muscular’ is somewhat misleading, as implants placed under the pec major are only partially covered by the muscle.The pec major covers the upper/medial half of the breast area, so a ‘sub-pectoral’ implant is truly subpectoral only in the upper and medial aspect of the augmented breast, while the lower and lateral aspect of the implant is actually in a sub-mammary position.Because sub-pectoral implants are, in reality, both sub-pectoral (upper/medial breast) and sub-mammary (lower/lateral breast), this placement has more recently been referred to as a ‘dual plane’ approach to breast augmentation.There is also ‘total submuscular’ implant placement, in which the implant is positioned behind the pec major and the serratus anterior muscle, so that the entire implant surface is covered by muscle tissue.This is not commonly done for cosmetic breast augmentations, but has been used for breast reconstruction using breast implants.There are a number of compelling reasons for selecting subpectoral placement over submammary placement.The most significant is that fact that radiologists have indicated that it is easier to image breast tissue by means of mammography when the implant is subpectoral.The pec major also provides an additional layer of tissue to conceal breast implants in the ‘social aspect’ of the breasts – that part that is easily visible in swimsuits and lower-cut clothing. Additionally, the pec major is quite effective at flattening the upper pole of a breast implant so that a natural slope for the upper aspect of the breast is created. Implants placed on top of the pec major tend to look very convex in the upper pole.The breast begins quite ‘abruptly’ in the upper aspect of the chest, and the appearance is therefore distinctly unnatural. Submammary implants are also more likely to have visible implant folds and ripples in the cleavage area.Another consideration is the fact that there is some evidence which suggests that the risk of capsular contracture may be lower with subpectoral implant placement.Even if the risk of contracture is the same, a mild contracture tends to be less noticeable and therefore less of a problem for the patient when the implants are in a subpectoral position.Submammary placement may produce a reasonable result for fuller figured patients with larger starting breast volumes, as the larger amount of natural subcutaneous fat and breast tissue helps to conceal the implant contours.The problem is that as breasts age, they tend to deflate – especially in the upper pole.So what was adequate implant coverage in the cleavage area at age 27 may be inadequate coverage at age 37, and implant folds and ripples gradually become visible.So subpectoral placement is the best choice for both the short and long term.‘Sub-fascial’ breast augmentation is also possible.Fascia is the term for a sheet of connective tissue made of collagen, and the pec major has a fascial covering as most muscles do.Breast implants can be placed behind the pec major fascia only, rather than behind the entire muscle, however this approach is not widely used.The pec major fascia is a relatively thin layer of tissue, so it is not nearly as effective in concealing breast implants as the actual muscle itself.Partial sub-fascial placement can be useful in some breast augmentation revision surgeries, where variations in pec major origin or incorrect release of the pec major has resulted in significant distortion of breast appearance when the muscle contracts.

When implants are placed under the muscle they are only partially covered by the muscle.  The top half or maybe the top two thirds of the implant is covered by the muscle.  In cases of mild ptosis, the breast tissue can be released from the muscle further than in the standard situation so that more of the implant is behind the breast tissue and the  muscle is allowed to ride a bit higher.  The degree to which the muscle and breast tissue can be released can be varied by the surgeon to get the desired result.Any augmentation, however, is not a substitute for a breast lift.  If your breast is too droopy any type of augmentation will not substitute for a breast lift.Best  of Luck.

Partial submuscular and dual plane breast implant positioning are exactly the same thing. Both refer to the concept that the lower border of the pectoralis muscle is often too high for an ideal breast implant location and part of the implant needs to sit below the edge of the muscle. This can be an effective breast augmentation technique for those women that have a small amount of breast ptosis. (sagging)

Thank you for your question.  What you are describing is basically the same technique.  In complete submuscular augmentation, the implant is placed under the pectoralis major muscle superiorly and medially (toward the middle) and by the serratus anterior muscle inferiorly and laterally (toward the outside).  This is rarely performed nowadays.  Most augmentations are placed in the subpectoral pocket and are considered partial submuscular because only the medial and superior portions of the implant are covered by the muscle. Dual plane refers to technique that differentially releases more of the muscle from the overlying gland.   The more extensive a dual plane procedure, the more the pectoralis muscle raises superiorly and the less the implant is covered but the muscle.  The advantage of a dual plane technique is that it can allow a borderline ptosis (sagging) patient avoid a breast lift by allowing the implant to stretch more of the breast gland inferiorly and allow for a slight nipple/areolar lift into a more centered position on the implant. The down side is potentially less coverage of the implant with muscle.  Best to be seen in person to see if you are a candidate for a dual plane augmentation without a breast lift.  Good luck.  

It is nearly impossible to do a completely submuscular implant.  Even in the situation where the dissection starts under the muscle it frequently extends laterally outside of the muscle.  You should try getting Vectra imaging done which will show you  your result without a lift to a highly reproducible degree.  Trying to get larger implants in order to push the nipples up frequently does not work.