This is a 33 year old white female 5’ 6.5” 133lbs and an avid runner. She is in very good health and has had 5 children the last 2 twins by c-section. Her bra size was a 34A with loss of superior fill and a slightly short nipple to inframammary fold distance. Having discussed the pros and cons of silicone versus saline she choose silicone and we did external sizing to the low 300cc range. Due to the slightly large nipple to areola complex she decided on a periareola approach. In order to achieve her desired goal she underwent a bilateral dual plane augmentation utilizing a 325 cc moderate plus smooth silicone implant. Her postoperative course was uneventful. Photos obtained two months postoperatively show well healed breasts with a nice superior fill. She has returned to her pre-pregnancy bra size. She is back running on a regular basis without any limitation. She is quite pleased with her results.