An unpleasant consequence of subpectoral implant placement is the occurrence of animation deformities during pectoralis muscle contraction. This study aimed to review the results achieved for 524 patients undergoing the triple-plane technique with respect to loss of animation deformities. The evaluation was performed by a group of three plastic surgeons according to the Spear grading system for breast distortion using a 4-point scale. Of the 524 patients evaluated, 351 (67 %) were rated as grade 1 (no distortion), 156 (29.77 %) as grade 2 (mild distortion), 17 (3 %) as grade 3 (moderate distortion), and 0 (0 %) as 4 (severe distortion).The excellent results achieved can be explained by the horizontal sectioning of the major pectoralis muscle at the areola level to the sternal margin. In fact, it determines that superior to sectioning of the muscle, its activity remains normal, with a low degree of dynamic deformities. On the contrary, inferiorly, at the muscular-aponeurotic plane level, no activity is detected, with no resultant animation deformities.
Level of evidence iv: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .