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 a smoother and straighter contour from collar-bone to nipple, thus hiding the ‘step’ along the implant’s upper edge that could otherwise result if the implant was placed in ‘front of the muscle’.
• there is reportedly less chance of ‘capsular contracture’.
• 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 that could be required for investigation of a breast lump at some time in the future.

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 give up.

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’ in order to avoid an obvious ‘step’ along 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, always be 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