Can a textured gummy bear implant be inserted through the areola?

The size of your areola and the size of your implant would be required to hazard an opinion. Please note that the areola does not necessarily have less chance of a keloid, and this location is linked with a higher chance of capsular contracture vs an incision below the breast.

Thanks for your question. In a patient who has a history of developing keloid scars, you are wise to consider which incisions will lead to the lowest chance of unsightly keloids. However, since inflammation and bacteria are known inducers of keloid scars, periareola incisions (bacteria in the breast ducts) are not what I would consider to be the best location, nor would I suggest axillary incisions, for these areas are warm, moist, with lots of bacteria in the sweat glands, and subject to arm movement, all increasing inflammation and higher risk of keloids. I would suggest that inframammary (crease) incisions will offer the least inflammation, fewest bacteria, minimal movement, and also best access for your surgeon to obtain precise hemostasis and the proper submuscular pockets to minimize caspsular contracture (CC), which would require re-operation (and another risk for keloid formation). I would also suggest submuscular implant placement, since submammary implant placement has a higher risk of CC, although textured implants do reduce these risks. But inserting them via periareolar incisions would increase the risk of keloid formation, IMHO. Also, you must have large areolas to allow this incision choice, and IF you do end up with keloids, they will be front and center, often uncomfortably tender and visible through clothing because of their protrusion.At least with inframammary (crease) incisions, if you end up with keloids, they will be hidden, and in an area where scar pad therapy can be held in place by your brassiere.As for round vs. teardrop-shaped, you need to read (click on the web reference link below) my Comprehensive Guide to Breast Augmentation--there is a whole section on choosing implants that discusses the pros and cons of round vs. shaped, smooth vs. textured, etc. Best wishes! Dr. Tholen

Thank you for the question.  In my opinion, much more important than selection of specific type of breast implant will be the patient's selection of  plastic surgeon.  You will find that it is likely that the selected plastic surgeon will have his/her preferences when it comes to the “ideal” breast implant type/size/shape, as well as the best incisional approach to achieve the specific patient's goals.
Generally speaking, the best online advice I can give to ladies who are considering  breast augmentation surgery (regarding breast implant size/profile selection) is:
1. Concentrate on choosing your plastic surgeon carefully.  Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. Ask to see lots of examples of his/her work. Sometimes, it is necessary to seek several consultations before you feel comfort will about your choice.
2. Have a full discussion and communication regarding your desired goals  with your plastic surgeon. This communication will be critical in determining  breast implant size/type/profile will most likely help achieve your goals. 
In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as  “natural” or "C or D cup”  etc means different things to different people and therefore prove unhelpful.
 Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup  size may also be inaccurate. Again, best not to discuss your goals and/or judge the outcome of the procedure performed based on achieving a specific cup size.
3. Once you feel you have communicated your goals clearly,  allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals.  Again, in my practice, this decision is usually made during surgery. I generally select appropriate breast implant size/profile after the use of temporary intraoperative sizers and viewing the patient's chest in the upright and supine positions.
I hope this (and the attached link, dedicated to breast augmentation surgery concerns) helps.