Breast Implant Positions

Implants can be placed in any one of four locations.

Each 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’re after.

1. Sub-Muscular (‘under the muscle’)

The implant is placed behind  the pectoral muscle.

The advantages of this position are:

  • It creates a more natural appearance because the muscle provides additional tissue coverage over the edges of the implant and thereby avoids a ‘stuck on’ look and visible ‘step’ along the upper edge of the implant.
  • There is less chance of visible Rippling/Wrinkling.
  • There is less chance of Capsular Contracture.
  • There is less interference with Mammograms.
  • There is less chance of interference with future 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 any breast diseases or be damaged during a fine needle biopsy of a breast lump.
Breast Implant

2. Sub-Glandular, (‘in front of the muscle’) – sometimes called ‘Pre-Pectoral’

The implant is placed immediately under the breast tissue itself, between it and the underlying pectoral muscle.

It is preferred to sub-muscular:

  • In those with mild or impending sagging of the breasts, constricted lower breast poles and tuberous breast deformities.
  • In those engaged in heavy, repetitive pectoral muscle exercises e.g. body builders, weight lifters.
  • However, it is not an option for women with thin chest wall tissue coverage as a ‘stuck on’ look would result from visibility of the implant edges not covered by sufficient chest wall tissue.

3. Sub-Fascial (‘in front of the muscle’ but ‘under its sheath’)

  • This is simply a variant of the ‘in front of the muscle’ position with basically the same advantages/disadvantages.

4. ‘Dual Plane’ Placement

A combination of positions 1 and 2 where the upper half of the implant is placed ‘under the muscle’ and the lower half is in direct contact with the lower breast:

  • The upper half of the implant is placed ‘under the muscle’ to help hide any ‘step’ along the implant’s upper edge that could occur if the implant was entirely ‘in front of the muscle’
  • The lower half of the implant is in direct contact with the breast to provide “fill” and “lift”.
  • This implant position is preferred in special situations such as mild sagging, constricted lower poles and ‘tuberous breasts’ when there is insufficient tissue coverage that would prevent placement of the implant ‘in front of the muscle’.  While such conditions might be equally corrected with an implant entirely ‘in front of the muscle’, the latter could produce a ‘stuck on’ look due to visibility of the implant edges in those women with thin chest wall tissue coverage.