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Dr. Parker Explains Why the Over vs. Under the Muscle Breast Implant Placement Debate is Over

How Dual Plane Breast Augmentation Settles the Score on Implant Placement

PARAMUS, N.J., Aug. 7, 2014 /PRNewswire/ -- Women considering breast augmentation have typically been presented with two options for implant placement: over the muscle or under the muscle. However, plastic surgeon Dr. Paul Parker says that the most commonly performed technique is the one patients are least likely to hear about: dual plane breast augmentation.

"In the past, plastic surgeons often explained breast implant placement in terms of over vs. under the muscle in an effort to simplify the concept," says Dr. Parker. "However, patients are now savvier about researching their options and this oversimplification is no longer helpful—it's confusing."

The dual plane technique is not new, notes Dr. Parker, explaining that when plastic surgeons refer to submuscular, partial submuscular or "under the muscle" breast implant placement, they are in fact almost always talking about dual plane breast augmentation.

"A dual plane augmentation situates the implant partially beneath the outer pectoral muscle while allowing it to expand naturally into the breast tissue in the lower portion. This ensures a smooth transition from the chest wall to the breast, adequate implant coverage and an optimal breast shape and position after augmentation."

How Dual Plane Implant Placement Works
During a dual plane breast augmentation, the pectoralis major muscle is released on two planes. First, the bottom of the muscle is released from the chest wall; next, the overlying breast tissue is partially released from the muscle. This allows the top portion of the implant to be covered by both breast tissue and pectoral muscle, while the remainder of the implant is covered by breast tissue only.

The exact degree to which the muscle is released from the breast tissue is determined on a case-by-case basis, depending on the patient's anatomy and aesthetic goals. The fact that the dual plane technique can be adjusted to achieve optimal implant placement for each individual makes it a superior choice for most breast augmentation patients, notes Dr. Parker.

He outlines the spectrum of dual plane breast augmentation options below:

  • Dual Plane I or "Partial Submuscular": the bottom attachments of the pectoral muscle are released from the chest and minimal breast tissue released from the "top plane" of the muscle. This is synonymous with the classic "partial submuscular" placement and is the most commonly performed option for patients who do not need to address sagging.
  • Dual Plane II: the pectoral muscle is released from the chest and from the overlying muscle, partially up to the nipple. Dr. Parker says this greater degree of top plane muscle release places the implant in the optimal position while also slightly raising the nipple/areola complex, allowing for correction of minor sagging without a breast lift.
  • Dual Plane III: the pectoral muscle is released from the chest and from the overlying muscle up to the nipple, allowing a surgeon to correct for a slightly greater degree of sagging than the Dual Plane II technique.

Dr. Parker points out that full submuscular placement—where the implant is completely covered by the pectoralis major muscle—is very rarely used during breast augmentation. He also mentions that subglandular breast implant placement, or "over the muscle," has generally fallen out of favor, as the implant's edges can be easier to detect beneath the skin.

About the Parker Center for Plastic Surgery: Board certified plastic surgeon Paul M. Parker, M.D., F.A.C.S., specializes in breast, body and facial cosmetic surgery for men and women as well as reconstructive skin cancer treatment as medical director of the Parker Center for Plastic Surgery, which he founded in 1985. The Parker Center also houses Beaura Spa, a full-service medical spa, and is located at 122 East Ridgewood Ave., Paramus, NJ, 07652. 201-967-1212. For more information, visit www.parkercenter.net or read Dr. Parker's reviews.

Media Contact: Dr. Paul M. Parker, Parker Center for Plastic Surgery, 201-967-1212.

SOURCE Parker Center for Plastic Surgery

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