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

BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: The 1/3 SMR technique combines benefits of submuscular and subfascial planes. It minimizes animation deformity, improves implant stability, and yields natural aesthetic outcomes.