To combine the benefits of both retroglandular and retropectoral positioning, the subfascial and the dual-plane techniques were introduced. The former is used to blunt the implant edge visibility that has been described with retroglandular implants and to avoid the shape distortion by muscular contraction that has been described for retropectoral implants. The latter consists of subglandular positioning in the inferior portion of the breast to give a more aesthetic appearance and retropectoral positioning in the superior portion to avoid superior-pole fullness. The authors have developed a different type of dual-plane mammaplasty with a subglandular approach and teardrop prostheses. It is called “reverse” for the subglandular positioning in the superior part of the breast and retrofascial in the inferior part, in contrast to the standard dual-plane approach. The procedure is described. The low risk of complications renders it a feasible and safe option for the aesthetic surgeon.
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