by Terrye Tebbetts
A pocket location discussion that brings interesting issues about where your breast implant should placed to light.
Question ~
I have gone on one consultation so far and am not certain if I want to go under the muscle. I was told because I was thin and due to my measurements would need under muscle. I do not know if any PS in my area do the dual plane technique, but this would be my first choice. Am I destined to go under the muscle due to my body type or should I continue with the consults and see what the others say?
Response #1
Sorry, not quite sure what you are asking…Usually when a PS refers to under the muscle he is talking dual plane (can anyone else back me up here?) but I do know that if your measurements from the base of the neck out to the nipple is less than a certain distance (20 or 22 cm, somewhere around there I think) then it is recommended to go under the muscle, thus dual plane.
I think it is important to go to a few consults so you get an idea of what is available to you, and how you feel about the different PS, and see what they all come up with.
And Terrye Tebbetts would kill me if I didn’t mention that a good PS is one who will measure you well, and decide on an implant based on what your breast tissues are capable of accepting.
Response #2 -
under and dual plane are not the same! under is completely under the muscle whereas dual plane means that only the top half is under the muscle the lower part is not covered by the muscle!
i would def. see more surgeons and hear more opinions but if all recommend under i would go with it. the results are what really matter, not so much how they are achieved!
Answer ~
Ok – Meg and Girly (got to love that name!) have given you good advice but both are still a tad bit misguided so let me see if I can make this a little more clear.
Measurements of your body should determine your pocket location – submammary (over), subfacial (very thin coverage and not highly recommended for many patients), subpectoral (partially under the pec but with old traditional methods that have 2 basic tradeoffs – 1. lateral displacement over time 2. more pain), total submuscular (used mostly in recon cases and must put the implant under pec and serratus muscles), and last but not least….Dual Plane (places the implant partial sub pec with newer techniques which eliminate the 2 negatives to the old sub pec listed above)
Dr. Tebbetts, one of the best breast augmentation surgeons in Texas, published Dual Plane in April of 2001 – you can read the scientific paper here
http://www.thebestbreast.com/news/downloads/pubs/04DualPlaneAugmentationPRSApril2001.pdf
Or you can read the chapter in the book about pocket location here
http://www.thebestbreast.com/book/chapter6.php
The determining measurement for where your implant should go is…..do you have 2 cm or more of pinch thickness in the upper pole of the breast? Most women who want an implant, simply don’t have the coverage there to satisfy this requirement.
Placing the implant under more of YOU, more soft tissue coverage, makes your result blend better into your own natural breast landscape, ages better with you (your tissue gets thinner and less elastic as time goes by…think about Grandma’s skin!), and it makes your mammograms easier long-term. With the advent of Dual Plane techniques – ladies – this really should even have to be a consideration any more. More coverage is better and if there are no negative side effects…why wouldn’t you?
Let me make it VERY clear, just because a ps says “unders” does NOT mean he or she is using Dual Plane!!! You must ask this question and be sure you get a clear answer.
Another great thing about Dual Plane is that there are 4 levels of it and those 4 levels can help a surgeon deal with various levels of ptosis (or sagginess) in a breast. A very valuable tool to have in your surgical arsenal!
About the Author: Terrye Tebbetts is one of the most knowledgeable women in the world about breast implants, with 27 years of experience educating patients and 11 years as a patient herself. For more information about breast implants or breast augmentation Dallas surgeons, please visit www.thebestbreast.com.