The question is about dual plane placement of implants. Because everybody says, “under muscle, and over muscle.” In reality, an under muscle implant is always a dual plane implant. The pectoralis muscle, the edge of the muscle ends from the corner up here on your shoulder down here to where it hits the ribs, and so the muscle is basically a big triangle.
The implant, at least half of it, if not two thirds of it, sticks out from under the edge of that muscle no matter what you do, so it’s always dual plane in that it’s under muscle for part of it over muscle, or over ribs, with no muscle coverage.
There is a technique where, in the process of the section, you take the muscle loose to various levels up in the breast that will allow the implant to push and help elevate a slightly low nipple that may avoid a lift. And that dual plane, there’s a dual plane one, two and three, there’s different levels, different ways to do the dissection but it’s the difference between under muscle and over muscle is part of that. How much you dissect up is what determines the lift of the nipple and that may be why you get a dual plane.