So, you’re looking into a breast augmentation, and you’ve begun researching implant placement techniques – that’s a great place to begin!
You’ve most likely come across terms like ‘over the muscle’, ‘under the muscle,’ and ‘hybrid’ and possibly it has all become a little complex. In this article I’ll try to clear up the confusion.
What does under the muscle or over it really mean with breast implants?
If you imagine the breast as a 4 layer cake. At the base is the rib cage, then the pec muscle, then the breast tissue including milk glands and fat, and then skin.
Over the muscle means placing the implant over that second layer, with only the breast tissue and skin supporting it. This can often look good in the short term, but can sag faster in the longer term. There are some cases where it may be appropriate however, such as for tuberous breasts when you need the implant to really push the breast tissue into a more regular shape.
Under the muscle means between the ribs and the pectoral muscle. This can be good for clamping the implant into position and the pec can help cover the implant at the top which helps avoid the obvious ridge between the skin and the implant, especially in very slim patients. But it doesn’t allow the implant to fully shape the breast.
What does ‘dual plane’ breast implant placement mean?
Dual plane involves placing the upper portion of the implant under the pectoral muscle, while allowing the lower half of the implant to sit directly under the breast tissue, over the pec muscle.
It is neither completely ‘under the muscle’ or ‘over the muscle,’ but a combination of both.
What are the benefits of dual plane?
- The most natural looking appearance
I find that the dual plane technique allows the breast implant to sit in the most natural position.
Because the upper half of the implant is placed ‘under the muscle,’ this technique helps to conceal any ‘step’ along the implant’s upper edge and avoids the ‘stuck on’ look.
And because the lower position of the implant is covered by breast tissue only, the implant provides superior lift and fills out the lower pole as it finds its natural resting position. So good cleavage, plus curves to the side and base of the breast.
- Good breastfeeding success rate
The dual plane placement I use reduces the risk of severing the milk ducts, nerves and breast tissue required for breast feeding.
This means that many women who have had a breast augmentation with me using this technique have been able to go on to successfully breast feed.
- Longer lasting
The pec muscle also helps to lock the implant into position for longer than I’ve seen from implants placed fully over the muscle which tend to drop a little faster.
- Ideal for anatomical (tear drop) breast implants
Over 90% of my patients choose anatomical implants for their ability to shape and lift. The dual plane technique is best suited to anatomical implants because the most projecting part of an anatomical implant is allowed to do the shaping and ‘lifting’ as it is over the muscle at that point. But it also means that there is enough pec muscle coverage of an anatomical implant in dual plane pocket to have the effect of ‘locking’ the implant into place and preventing downward movement and rotation.
What is my preferred technique?
After reading to this point, I’m sure you can guess that I favour the ‘dual plane’ technique of implant placement as it provides some of the best results possible in breast augmentation surgery.
This technique is customisable and allows me to adjust the implant placement to varying degrees based on my patient’s anatomy and aesthetic goals.
We have a great animated video under the Breast Augmentation tab on our website that demonstrates how the dual plane placement is performed.
It is important to highlight that there are times when I will recommend completely over the muscle too however – being in cases of tuberous breasts or other complex cases.
Want to discover more about breast augmentation?
A great way to ‘Try before you buy’ is to come in and have a $100 Vectra 3D surgery simulation with my Practice Manager Jessica.
Many patients love this service because it gives them a much better idea of sizing and placement than simply putting sizing implants in a bra can! And the $100 cost is rebated against your consultation with me if you decide to continue exploring if the surgery is right for you. You can learn more and even book online here.
Call us on 4920 7700 to make an appointment or use the contact form below.
Blog Author:
Dr Nicholas Moncrieff, Cosmetic Plastic Surgeon
About Dr Moncrieff
Dr Moncrieff focuses exclusively on breast reductions, breast lifts, breast augmentation, tummy tucks and body lifts.
He is one of only a handful of Plastic Surgeons across Australia with this sole breast and body focus.
Dr Moncrieff has performed thousands of surgical procedures over more than two decades in medicine. Over 20,000 of these procedures have been in Newcastle.
More information about Dr Moncrieff is available here.
