This is a 37 year old white female with no history of previous surgery and no children. She is 5’4” and 140lbs. Her bra size was a 34B with a slightly lower positioned nipple/ areola complex. She has a tight lower pole. After preforming external sizing she chose a 450cc moderate plus smooth silicone prosthesis and underwent bilateral subpectoral augmentation with a release of the lower pole. She had an unremarkable postoperative course and photos obtained at three months show that she has had significant improvement in the appearance of her breasts. They are now round with a proper balance between the upper and lower pole and better medial fill. She is back to all normal activities and is quite happy with her surgical results.