Aesthetic Plastic Surgery

, Volume 37, Issue 4, pp 715–718 | Cite as

Triple-Plane Technique for Breast Augmentation: Solving Animation Deformities

  • Roberto Bracaglia
  • Damiano TambascoEmail author
  • Stefano Gentileschi
  • Marco D’Ettorre
Original Article Breast


An unpleasant consequence of subpectoral implant placement is the occurrence of animation deformities during pectoralis muscle contraction. This study aimed to review the results achieved for 524 patients undergoing the triple-plane technique with respect to loss of animation deformities. The evaluation was performed by a group of three plastic surgeons according to the Spear grading system for breast distortion using a 4-point scale. Of the 524 patients evaluated, 351 (67 %) were rated as grade 1 (no distortion), 156 (29.77 %) as grade 2 (mild distortion), 17 (3 %) as grade 3 (moderate distortion), and 0 (0 %) as 4 (severe distortion).The excellent results achieved can be explained by the horizontal sectioning of the major pectoralis muscle at the areola level to the sternal margin. In fact, it determines that superior to sectioning of the muscle, its activity remains normal, with a low degree of dynamic deformities. On the contrary, inferiorly, at the muscular–aponeurotic plane level, no activity is detected, with no resultant animation deformities.

Level of Evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors


Animation deformities Breast augmentation Triple-plane technique Subpectoral implant placement Dual plane 


  1. 1.
    Bracaglia R, Gentileschi S, Fortunato R (2011) The “triple-plane technique” for breast augmentation. Aesthet Plast Surg 35:859–865CrossRefGoogle Scholar
  2. 2.
    Bracaglia R, D’Ettorre M, Gentileschi S, Tambasco D (2012) Vacuum-assisted breast implant insertion in primary augmentation mammaplasty. Aesthet Plast Surg 36:472–473CrossRefGoogle Scholar
  3. 3.
    Spear SL, Schwartz J, Dayan JH, Clemens MW (2009) Outcome assessment of breast distortion following submuscular breast augmentation. Aesthet Plast Surg 33:44–48CrossRefGoogle Scholar
  4. 4.
    Henriksen TF, Fryzek JP, Holmich LR et al (2005) Surgical intervention and capsular contracture after breast augmentation: A prospective study of risk factors. Ann Plast Surg 54:343–351PubMedCrossRefGoogle Scholar
  5. 5.
    Peters W, Smith D, Fornasier V, Lugowski S, Ibanez D (1997) An outcome analysis of 100 women after explantation of silicone gel breast implants. Ann Plast Surg 39:9–19PubMedCrossRefGoogle Scholar
  6. 6.
    Dempsey WC, Latham WD (1968) Subpectoral implants in augmentation mammaplasty: preliminary report. Plast Reconstr Surg 42:515–521PubMedCrossRefGoogle Scholar
  7. 7.
    Regnault P (1977) Partial submuscular breast augmentation. Plast Reconstr Surg 59:72–76PubMedCrossRefGoogle Scholar
  8. 8.
    Lindsey JT (2004) The case against medial pectoral releases: a retrospective review of 315 primary breast augmentation patients. Ann Plast Surg 52:253–256PubMedCrossRefGoogle Scholar
  9. 9.
    Tebbetts JB (2001) Dual-plane breast augmentation: optimizing implant–soft tissue relationship in a wide range of breast types. Plast Reconstr Surg 107:1255–1272PubMedCrossRefGoogle Scholar
  10. 10.
    Regnault P (1977) Partial submuscular breast augmentation. Plast Reconstr Surg 59:72–76PubMedCrossRefGoogle Scholar
  11. 11.
    Pelle-Ceravolo M, Del Vescovo A, Bertozzi E, Molinari P (2004) A technique to decrease breast shape deformity during muscle contraction in submuscular augmentation mammaplasty. Aesthet Plast Surg 28:288–294CrossRefGoogle Scholar
  12. 12.
    Pardo Mateu LM, Chamorro Hernandez JJ (1998) Partial myotomy of the pectoralis major in submuscular breast implants. Aesthet Plast Surg 22:228–230CrossRefGoogle Scholar
  13. 13.
    Richards A, Ritz M, Donahoe S, Southwick G (2001) Botox for contraction of pectoral muscles. Plast Reconstr Surg 108:270–271PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York and International Society of Aesthetic Plastic Surgery 2013

Authors and Affiliations

  • Roberto Bracaglia
    • 1
  • Damiano Tambasco
    • 1
    Email author
  • Stefano Gentileschi
    • 1
  • Marco D’Ettorre
    • 1
  1. 1.Department of Plastic and Reconstructive SurgeryCatholic University of the Sacred HeartRomeItaly

Personalised recommendations