Dual-plane vs submuscular through the armpit: which pocket, and why

Dual-plane — the usual answer

The upper two-thirds of the implant sits under the pectoralis major; the lower attachments of the muscle are released at the fold so the lower pole of the implant sits under breast tissue. The result is a soft upper slope with cover and a full, natural lower pole — and less animation than a full submuscular pocket. The endoscope is what makes the release precise.

Full submuscular

The whole implant under the muscle: maximum cover for very thin patients and the lowest rippling risk, at the price of more animation with chest contraction and a slightly longer settling curve. Chosen for specific anatomy and for patients who prioritise cover over everything.

Subglandular

Over the muscle, under the breast tissue: no animation, fastest settling, but the least cover and the highest rippling and visible-edge risk in thin tissue. Rarely chosen through the armpit, because the route's instruments and endoscope are designed for the planes beneath the muscle.

Choosing

Tissue pinch, breast width, degree of droop and activity level decide. Athletes who flex a lot may prefer dual-plane over full submuscular; very thin patients lean toward more cover; mild droop benefits from dual-plane's lower-pole fill. The technique page shows how each is made.