Breast augmentation is usually performed in subglandular, subfascial, or partial submuscular pockets, including the dual plane. A new pocket has been introduced by the new technique of muscle splitting breast augmentation. The initial pocket was made in the subglandular plane up to the lower level of the nipple–areolar complex, and the submuscular plane was reached by splitting the pectoralis major muscle without its release from the costal margin. The implant now lies in this plane simultaneously behind and in front of the pectoralis. The technique was first published in the Springer Journal for Aesthetic and Plastic Surgery three years ago, and since then it has been adopted by aesthetic plastic surgeons from around the world due the highly successful and aesthetically pleasing results achieved using this technique.
The split muscle technique is much less painful than complete sub-pectoral muscle placement as less volume has been unnaturally squeezed under the muscle.
Breast enlargement on very slim women can leave a visible implant outline and in some cases, the edge of the implant ripples. This new split muscle technique hides the top part of the implant so the potential problem of rippling is avoided and gives the cleavage a natural curve leading down to a fuller lower pole.
The two ways projection is improved in the split muscle technique:
1. When placed under the muscle as in a conventional sub pectoral augmentation, the implant can flatten and a great deal of ‘perkiness’ is lost; with the split muscle technique only the top part of the implant is covered by muscle leaving the bottom half full and rounded.
2. The weight of the muscle on the top half of the implant places pressure on the silicone gel in the lower half of the round implant, giving a very natural look with full projection.