Augmentation mammoplasty can be approached in various methods according to the type of implant   and implantation site depending on the status of the patient or surgeons preferrence. The advantages for submuscular placement is based on problems associated with subglandular placement, especially capsular contracture, sensory changes in the nipple, and interference with the interpretation of mammograms are avoided. There are fewer complications such as hematoma, infection and extrusion of the implant with submuscular dissection and relatively avascular,  minimal sensory changes in the nipple compared to subglandular approach. 
 The submuscular periareolar approach to augmentation mammoplasty was first described in the 1970s.  This approach provides easy access to both the subglandular and subpectoral planes. Also provides a central point of access for creation of the implant pocket, which allows for easier and more accurate dissection in all diameter. The resultant periareolar scar is usually minimal with less injury to breast parenchyme and eventual biopsy or mastectomy incision to be performed through or around the areola.
 During the period of March. 1999 - January. 2000, 19 patients who received submuscular periareolar augmentation mammoplasty under general anesthesia  resulted favorable scar with accurate access to pocket margin, easier dissection, and less bleeding compared to submuscular transaxillary augmentation mammoplasty. We experienced submuscular periareolar approach to breast augmentation was highly versatile, safe, less pain and postoperative hematoma incidence was greately reduced with minimizing breast tissue injury achieving excellent results in breast augmentation.