Dual Plane Breast Augmentation Is Popular, But Is It Necessary?

If you’re exploring breast augmentation in 2026, you may be doing your homework and coming across terms like dual plane breast augmentation, above-the-muscle placement, and newer implants such as Motiva® Ergonomix®. My goal as a female board-certified plastic surgeon is to help you cut through the noise, understand your options, and feel empowered to make the best decision for your body.

One of the most common things I hear is: “I saw another surgeon who recommended dual plane breast augmentation, what do you think about that?” Let’s take a deep dive—because the answer lies in how far silicone breast implant technology has come in the past decade. Surgeons need to evolve with advances both in our field and in women’s lives. Women are pushing their bodies further, working out more and intentionally building muscle mass as studies show increasing ties between muscle mass and cognition later in life. We want to support women, not restrict them. Learn more about this shift in plastic surgery approaches and why you should advocate to have the best possible result for you right now, and for ten years down the line.

Dual plane breast augmentation is a technique where the implant sits partially under the chest muscle (pectoralis major) and partially under breast tissue. To achieve this, the lower edge of the muscle is surgically cut so the implant can “slide” downward vertically along your chest wall, so the muscle still covers the top portion but your breast covers the bottom half.

Historically, surgeons (including me!) used this approach to:

• Improve upper-pole coverage
• Reduce a visibly “fake” look, especially in thinner patients to camouflage the top of the implant
• Minimize capsular contracture risk, which is more common with older generation implants placed above the muscle.

Originally described in 2001, over two decades ago, dual plane breast augmentation was an innovative solution. Not anymore. We have better breast implants now, so we don’t have to sacrifice the muscle for beautiful aesthetic results that last.

Dual plane was born out of necessity—not because it was ideal, but because older implants required plastic surgeons to adapt your body to the implant. That meant cutting muscle to camouflage limitations in implant design. That paradigm has shifted with recent technological advances.

With advanced options like Motiva Ergonomix implants, we now have modern breast implants that adapt to your body, not the other way around. As a result, techniques like dual plane are increasingly outdated and, in my opinion, inferior for most women.

Here’s why I’ve moved away from dual plane breast augmentation:

• It involves unnecessary cutting of healthy muscle
  • Now that we have superior, gummy bear gel implants with a natural teardrop look, we can place them above the muscle and still look natural.
• Implants under the muscle cause animation deformity
  • Every time a pec major (that has been cut for dual plane) contracts, it pushes implants down and out to the side. This does not occur with over the muscle implants
  • Over time the implants stay in this abnormal position leading to implant malposition, bottoming out, or lateralization.
• Many studies in the past few years show muscle strength is directly tied to cognition, especially for women perimenopause and beyond.
  • Cutting your pectoralis major muscle now, knowing that you will need that and other large muscles to maintain healthy cognition well into old age seems irresponsible when we have so many better options.

Motiva Ergonomix implants represent a major advancement in breast implant options. They are designed to behave more like natural breast tissue—and that changes everything.

Key features include:

• A natural teardrop shape when standing, with a proportionate upper pole fill that is gradual, not overdone
• Dynamic movement that shifts naturally with your body
• 100% fill while upright, minimizing rippling seen with other implants
• A softer, more adaptive gel that camouflages beautifully under the skin
• SmoothSilk surface which is much less likely to cause capsular contracture when compared to competitors.

Because of this design, we can safely and confidently perform above-the-muscle breast augmentation while still achieving a soft, natural breast augmentation result.

In the past, placing implants above the muscle was limited by concerns such as:

• A visible implant edge
• An unnatural, overly round appearance
• Higher capsular contracture rates with older implants

Motiva Ergonomix has changed those limitations.

• No muscle cutting or disruption
• Faster recovery and less postoperative pain
• No animation deformity (breast movement with muscle flexing)
• Beautiful upper-pole camouflage without a “fake” look
• Lower capsular contracture rates compared to older implant styles
• Preservation of your pectoralis muscle
• Upper pole volume boost that resembles a naturally full breast

This is a perfect example of how plastic surgery education and technology evolve together to improve patient outcomes.

Many women worry that going above the muscle means sacrificing natural aesthetics. Today, that simply isn’t true. With the right implant, proper sizing, and an individualized surgical plan, you can enjoy:

• Softness
• Natural movement
• Balanced fullness
• Long-term safety

Modern breast implant placement should focus on working with the body, not against it.

If you’re exploring your options, here are a few key takeaways:

• Ask your surgeon why they recommend a specific technique
• Understand that older techniques may not reflect current best practices
• Focus on implant technology—not just placement
• Choose a surgeon committed to ongoing education and innovation
• If your surgeon does things the same way for twenty-five years, then they are not changing with the science or adapting their techniques to fit the needs of modern patients.

Dual plane breast augmentation played an important role in the past, but in 2026, we have better, safer, and more natural solutions. With Motiva Ergonomix implants, we no longer need to cut muscle to achieve beautiful results.

If you’re considering breast augmentation and want a truly natural breast augmentation tailored to your body, know that you have more options than ever before. My mission is to guide you through those options with transparency, compassion, and evidence-based care.

If you have questions, I’m always here to help. Call our office to schedule a consultation (919) 797-0996.