In a breast augmentation surgery, the placement of breast prostheses can be basically summarized in four types of technique, depending on the location plane:
1. Subglandular plane (breast prostheses are placed between the muscle and the gland)
2. Subfascial plane (breast prostheses are located between the membrane called
fascia and muscle)
3. Total retromuscular plane (the breast prostheses are located behind all the
chest wall muscles)
4. Partial retromuscular plane or dual plane (breast prostheses are placed only behind
pectoralis major muscle)
Breast augmentation: What is the most suitable location for breast prostheses?
In the opinion of Dr. Cristina Brasó, the technique that provides the best results in breast augmentation is partial or dual placement in the retro-muscular plane. With this technique, the breast prostheses are placed just below the pectoralis major muscle which, anatomically, does not reach below the areola.
When placing breast prostheses using the dual plane, the upper two thirds of the breast prosthesis will be located under the muscle but the lower third will not, it will be in a more superficial plane.
The advantage of placing breast prostheses using a dual plane is that it allows the muscle to cover the entire upper pole and provides naturalness to the neckline and the upper area of the breast but, at the same time, does not interfere with the practice of physical exercise and allows the prosthesis expands the skin of the lower pole well and that the breast remains in an adequate position.
Placing the prosthesis through the sub-glandular plane provides a more artificial breast augmentation result as the prosthesis is closer to the surface and more apparent. My experience also tells me that the sub-fascial plane is very virtual since the membrane called fascia in many cases is very thin and ends up disintegrating, especially in the upper pole. For this reason it ends up being like the sub-glandular plane.
For its part, the placement of the prosthesis through the total retro-muscular plane is not adequate because the breast prosthesis is too caught by the entire muscular package and has a tendency to remain too high, interfering with movements and physical exercise.