I have small nipples and a small chest. What would be best approach?

Hello thank you for your question. Sometimes surgeons style and technique can vary. There are several types of approaches for where to make the incision. Given the size of the implant and that it is silicone will limit where you can place the incision. You can do peri areolar or IMF. Some surgeons can also do transaxillary approach (through the armpit) leaving no scars on the breasts. Everything else is a personal preference based on your anatomy and the look you are going for. Of course without a proper physical examination it is difficult to assess and give you accurate advice. You should seek in person consultation with your plastic surgeon.

In my hands, I would use the incision under your breasts. I do not use the axillary incisions because of the higher risks and difficulty reusing this incision. Please discuss this with your surgeon.

You appear to be a great candidate for breast augmentation and should expect very nice results. You can elect to have the implants placed through a small inframammary incision. This approach is very common and the incisions tend to heal very well. I've included a video on breast augmentation I hope you find helpful.