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Dual-plane breast augmentation refers to the placement of a breast implant in a specific anatomic position — partly behind the pectoralis muscle, and partly behind breast tissue. The layers of the breast, from external to internal, are skin, breast tissue, pectoralis muscle and ribs. Plastic surgeons have debated the best plane for implant placement over many decades — some preferring placement between the breast tissue and the muscle (the “subglandular plane”), and others preferring placement between the muscle and the chest wall (the “submuscular plane”). There are advantages and disadvantages to each. The “dual plane” was first described by Dr. John Tebbets in 2001 as a way to combine the advantages of both.
In the dual plane approach, the lower origin of the pectoralis muscle is detached from the chest wall and separated from the lower part of the breast tissue. This allows the muscle to slide upward slightly. When the implant is placed, the upper portion is covered by muscle and breast tissue, while the lower portion is covered by breast tissue alone. The upper muscle coverage of the implant reduces the risk of rippling and implant visibility in the upper part of the breast, capsular contracture, and disruption of cleavage (synmastia), while improving mammography accuracy. At the same time, the lower part of the breast implant that is covered by breast tissue benefits from a smoother implant-breast transition, enhanced shape, and a more natural look and feel.
The dual plane technique comes in very handy in cases of breast deflation with ptosis (sagging), which occurs after having children, breastfeeding, losing weight, or naturally with time. In these cases, a dual plane allows the implant to be placed slightly lower to fill the lower pole of the breast and give a lifted appearance during breast augmentation. This does not replace the need for breast lifting (mastopexy) in moderate to severe cases, but it does occasionally prevent the need for lifting in more mild cases.
Drs. Donaldson and Sieffert prefer dual plane breast augmentation for all of the benefits mentioned here. At Donaldson Plastic Surgery, our patients consistently comment on how proportionate and natural their results look, and how quickly they recover with minimal pain. We’ve used the dual plane approach to help over a thousand patients achieve their goals — safely, predictably and beautifully!
*Earned by Dr. Donaldson