“Reverse” Dual-Plane Mammaplasty

  • Gianpiero Gravante
  • Gaetano Esposito


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.


Pectoral Muscle Breast Augmentation Major Pectoral Muscle Dense Connective Tissue Breast Asymmetry 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. Sarwer DB, Nordmann JE, Herbert JD: Cosmetic breast augmentation surgery: a critical overview. J Womens Health Gend Based Med 2000;9(8):843–856PubMedCrossRefGoogle Scholar
  2. Biggs TM, Yarish RS: Augmentation mammaplasty: retropectoral versus retromammary implantation. Clin Plast Surg 1988;15(4):549–555PubMedGoogle Scholar
  3. Vazquez B, Given KS, Houston GC: Breast augmentation: a review of subglandular and submuscular implantation. Aesthetic Plast Surg 1987;11(2):101–105PubMedCrossRefGoogle Scholar
  4. Reynaud JP, Tassin X: Past, present and ... future of breast implants. Ann Chir Plast Esthet 2003;48(5):389–398PubMedCrossRefGoogle Scholar
  5. Young VL, Watson ME: Breast implant research: where we have been, where we are, where we need to go. Clin Plast Surg 2001;28(3):451–483PubMedGoogle Scholar
  6. Graf RM, Bernardes A, Rippel R, Araujo LR, Damasio RC, Auersvald A: Subfascial breast implant: a new procedure. Plast Reconstr Surg 2003;111(2):904–908PubMedCrossRefGoogle Scholar
  7. Graf RM, Bernardes A, Auersvald A, Damasio RC: Subfascial endoscopic transaxillary augmentation mammaplasty. Aesthetic Plast Surg 2000;24(3):216–220PubMedCrossRefGoogle Scholar
  8. Tebbetts JB: Dual plane breast augmentation: optimizing implant-soft-tissue relationships in a wide range of breast types. Plast Reconstr Surg 2001;107(5):1255–1272PubMedCrossRefGoogle Scholar
  9. Spear SL, Carter ME, Ganz JC: The correction of capsular contracture by conversion to “dual-plane” positioning: technique and outcomes. Plast Reconstr Surg 2003;112(2):456–466PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2009

Authors and Affiliations

  • Gianpiero Gravante
    • 1
  • Gaetano Esposito
    • 2
  1. 1.Research Fellow of Physiology,University of Tor VergataCiampinoItaly
  2. 2.Centro Ustioni OspedaleUniversity of Tor VergataRomaItaly

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