One-Third Pectoral Muscle Coverage in Breast Augmentation: The Selective Muscle Recruitment Technique for Natural Results and Minimized Complications.

Abstract

Breast augmentation is one of the most common cosmetic surgery. Current implant pocket techniques vary in aesthetic outcomes and complications. We introduce a new approach, the 1/3 Selective Muscle Recruitment (SMR), designed to optimize implant coverage and minimize animation deformities. A retrospective study was conducted on 110 patients undergoing 1/3 SMR between September 2022 and November 2024. The upper third of the implant was placed submuscularly under segment 3 of the pectoralis major, while the lower two-thirds was placed subfascially. Visual analog scale (VAS) scores were used to assess pain and satisfaction. Complications and outcomes were evaluated clinically and photographically. All patients completed follow-up (mean: 11.7 months). Most (84%) underwent mastopexy with implant placement. Complications were minimal (10%) with no seroma or capsular contracture. Pain was mild (VAS 2-5), and 87% of patients rated satisfaction ≥8. Animation deformity was absent in 92% of cases. The 1/3 SMR technique combines benefits of submuscular and subfascial planes. It minimizes animation deformity, improves implant stability, and yields natural aesthetic outcomes.