If you get an areola incision, can the implant be placed under the muscle?

A plastic surgeon might be able to use a periareolar incision for retromuscular breast implant placement, but it is very difficult. This incision can a create a pale, depigmented, visible scar right in the line of sight and also  exposes the implant to bacteria within the nipple/areola tissue. For these and a few other reasons, many surgeons avoid using this incision. A small, thin scar in the crease under the breast hides very well as it mimics the crease and avoids all of the problems just mentioned. This is why it is probably the most popular incision choice by plastic surgeons and their patients alike.

The implant can be placed under the muscle from a peri-areolar, IMF and trans-axillary incision.  There a various advantages and disadvantages to each of these approaches. 

The peri-areolar approach can be very popular as the scar can be hidden at the border of the areola and the natural skin. From this approach, you can place the implant above or below the muscle.  This approach tends to be very popular in patients that have darker skin as the areolar border tends not to keloid or become hypertrophic as it may be more prone to do in other areas. 

The areola incisions are often incorporated in surgeries where patient are also going to have a lift as part of their augmentation to enhance the overall shape of their breasts. 

All three approaches to a breast augmentation can give you a phenomenal result if done correctly.  It is important to discuss with your surgeon their personal preference in terms of approach.  There are some patients that benefit from one approach versus another in specific circumstances. 

Please discuss your breast augmentation surgery with your board-certified plastic surgeon that performs a high volume of breast implant surgeries.   

The incision choice is independent of the implant placement, so yes, this is certainly possible.  Be sure to discuss your goals and concerns with your board certified plastic surgeon and consider the pros and the cons. Be certain your surgeon is properly certified.  I've attached a link where you can start your search.