This I usually discuss with my patient as I’m happy with all three approaches: in the fold under the breast (inframammary), through the armpit (transaxillary) or through the nipple areola complex (transareolar or periareolar). Personally, I don’t like inserting the implant through the nipple areolar complex, for a number of reasons. Apart from small risks to nipple survival, denervation and breast feeding, there are important risks from scarring. Usually scars heal very well in the areola (the darker or pinker area around the nipple). However there are two situations which worry me. One is trying to get a larger implant through a smaller areola and the risk of the incision tearing into the surrounding breast skin with subsequent uncorrectable bad scarring and second is the risk of scar contracture deforming the shape of the nipple itself. For those reasons I recommend either under the breast or through the armpit.