A recent article in Plastic and Reconstructive Surgery (October 2011) out of the United Kingdom documented a higher incidence of sensation loss of the nipple/areola area and more pain in the areola with breast augmentation incisions made around the edge of the areola compared to incisions made in the crease under the breasts. The incision around the areola also requires the surgeon to tunnel into the breast tissue in order to get to the space underneath the breast tissue in order to place the implant.
Cutting through the breast ducts potentially also increases the risk of contamination and infection of the implant because the ducts in the breast that are cut through this approach are not sterile. These issues along with a much more hidden scar make the crease incision the preferable route for breast implant surgery for the majority of plastic surgeons. Keeping the scar in the crease underneath the breast makes it well hidden and less noticeable than a scar on the front of the breast around the areola in addition to potentially having a lower risk of infection.