Breast Augmentation pocket planes explained:
A lot of women considering and researching breast augmentation are still confused about what the different pocket planes into which breast implants can be placed and, in particular, which pocket plane will best suit their body.
In essence, there are two pocket planes that a breast implant can be put into: OVER the muscle (sub-glandular, sub-fascial) and UNDER the muscle (sub-pectoral, sub-muscular). A further refinement of the under-the-muscle pocket plane is the DUAL-PLANE technique. The over-the-muscle technique involves creating a pocket under the breast tissue so that the only thing covering the implant is breast and skin. The under-the-musclel technique, on the other hand, has the implant placed under the pectoralis muscle, such that the implant is covered by muscle as well as breast and skin. The dual-plane technique is a modifiable and customised method by which we create a pocket in which the top portion of the implant is positioned under the muscle whilst the lower part of the implant is positioned under breast and skin.
There are advantages and disadvantages to each pocket plane, and indications for each are dependent on the patient’s body type and clinical findings. In general however, most patients seeking breast augmentation are best suited to having their implants placed under the muscle in a dual-plane fashion.
The dual-plane technique is a refinement of the under-the-muscle pocket in breast augmentation. In this technique, the pectoralis muscle is released from its attachments such that the “roof” of the pocket (and tissue which will cover the front part of the implant) is made up of muscle in the upper portion and breast tissue in the lower portion. The advantage of having the upper part of the implant under the muscle is that this is where having extra tissue coverage and protection can be beneficial, especially in the long term, when breast tissue gets thinner in the upper pole. In the dual-plane technique, having breast and skin over the lower part of the implant allows the implant to more effectively expand out the lower pole of the breast, thus creating a more pleasing aesthetic result. A customised dual-plane technique allows the surgeon to tailor the areas of the implant we want to be covered by muscle, and also define the areas where we want the breast and skin to be expanded by the implant.
There is no one standard technique in terms of pocket plane that will qualify for every patient seeking breast augmentation. In order to achieve the desired result, one must develop a customised approach taking into consideration the patient’s existing anatomy, and selecting the most appropriate size, shape, and type of implant.