The periareolar incision (#1) is placed at the outer edge of the brown pigment zone around the nipple (the areola).  This incision consistently produces the best scar quality of the three incisions I use.  The reason for the good scar quality is the thinness of the areola skin.  Thin skin typically heals with much less conspicuous scaring than thicker skin.  The incision is nicely camouflaged by the color change between the brown areola skin and the white breast skin.  For procedures done under local anesthesia it requires significantly more local anesthetic than the inframammary fold incision.  Most patients who select periareolar incision have general anesthesia for their procedures.

 

Illustration from Aesthetic Plastic Surgery, Second Edition by Thomas D. Rees, MD, and Gregory S. LaTrenta, MD.  Published by W.B. Saunders Company.  Used by permission.