1. Sub-muscular (‘under the muscle’):  This refers to the implant being placed behind the pectoral muscle.  Dr Mayson  recommends this location whenever possible for the following reasons:

• more importantly than for any other reason, it creates a more natural appearance because the muscle over the implant provides additional tissue coverage and thereby helps to hide any ‘step’ along the edges of the implant, particularly at the upper pole of the implant, that could otherwise occur if the implant was placed in ‘front of the muscle’.
• there is less chance of visible rippling/wrinkling
• there is less interference with mammograms.
• there is less chance of interference with breast feeding.
• it is less contributory to future sagging of the breasts.
• the implants are further away from the breast tissue and are therefore less likely to be involved in breast diseases or be damaged during any fine needle biopsy of a breast lump.

2. Sub-glandular (‘in front of the muscle’): This refers to the implant being placed immediately beneath the breast tissue itself, between it and the underlying pectoral muscle.  This location is preferred to sub-muscular in those with sagging breasts or those engaged in repetitive pectoral muscle activities which they do not wish to stop.

3. Sub-fascial:  A variation of the ‘in front of the muscle’ location.

4. ‘Dual Plane’ Placement:  A combination of positions 1 and 2 where the upper half of the implant is positioned behind the muscle and the lower half is behind the breast. This is Dr Mayson’s preferred procedure when there is sagging of the breasts – the reason being that the lower half of the implant provides ‘lift’ to the breast while the upper half of the implant is placed ‘under the muscle’ to help hide the ‘step’ at the upper edge of the implant that could otherwise result if the implant was entirely ‘in front of the muscle’.  This ‘step’ along the upper edge of the implant gives the breast a very unnatural ‘stuck on’ look and should, if possible, be always avoided.

Each implant position has its advantages and disadvantages.  Which implant position is best for you will depend on your breast characteristics, lifestyle, preferred implants and most importantly the look you desire.

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- Danielle, Miranda, NSW