Implant location:  in front of or behind the chest muscle?

Both silicone and saline implants can be placed either subglandular - below the breast tissue but above the pectoralis major chest muscle, or subpectoral - beneath the chest muscle.  This decision is usually dictated by the existing amount of breast tissue, skin and muscle tone, weight and body type.  If there is not much breast tissue to begin with, the final results will be more natural if the implant is placed beneath the muscle. There are a number of other reasons why placement beneath the muscle is preferred, and your surgeon will give you all the facts you need to decide.

Incision location: periareolar, inframammary, transaxillary, or transumbilical?

The options are an incision made (a) around the edge of the nipple, (b) in the fold under the breast, (c) under the arm, or (d) through the belly button area.  One factor that will automatically determine location is if silicone implants are chosen they can only be inserted through an inframmary incision in the fold under the breast.  Saline implants, which can be deflated for insertion, can be inserted through the smaller incisions made in the other three locations.  The pros and cons of these combinations will also be fully explained by your board-certified plastic surgeon.