A dual plane breast augmentation refers to a technique whereby the implant is partially covered by muscle and partially covered by breast tissue. The word “dual” means two. The word “plane” refers to the loose connections between two adjacent tissue layers. In this case it refers to the loose connections between the pectoralis major muscle and the overlying breast tissue. Dual plane breast augmentation makes it possible to have the benefit of a subglandular implant while maintaining all of the benefits of a submuscular implant. The major benefit of a subglandular implant is the ability to fill out the lower part of the breast without the potential restriction of the underlying muscle. There are more benefits, however, of a submuscular implant compared to a subglandular implant. A submuscular implant has less incidence of capsular contracture, it provides more coverage over the implant thereby creating a more natural look and feel. It also helps in reducing the chance of visible wrinkling and mammography is more accurate. When conditions exist whereby the muscle restricts the implant from filling out the lower part of the breast, a dual plane augmentation can be of great benefit. Some of these conditions include: Mild ptosis (sag) or a constricted lower pole. The word “pole” refers to the lower part of the breast. It is also very helpful in situations which require lowering of the breast crease and still maintaining submuscular placement of the implant.
There are three general types of dual plane dissection. Each is chosen pending on the degree of release necessary and the particular condition to be treated. Type I refers to complete division of the pectoralis major muscle along the inframammary fold without separating it from the overlying breast tissue. Type II includes complete separation of the pectoralis major muscle along the entire inframammary fold and release of the breast tissue from the muscle up to the bottom of the areola. Type III includes complete release of the pectoralis major at the fold of the breast and separation of the breast tissue from the muscle up to the top of the areola.
In properly selected patients the dual plane technique has been found to effectively fill out the lower part of the breast in patients with mild ptosis (sag), thereby preventing the need for a breast lift. It’s helpful in preventing a “double bubble” deformity when a submuscular implant is placed and the fold needs to be lowered. It is also very helpful in reshaping a restricted lower pole when using a submuscular implant.