This is a 30 year old healthy white female. Her only previous surgery was a breast augmentation preformed nine years ago. She is 5’6” and 150lbs and she has not had any children. Her bra size was a 34B-C and she had 350cc implants placed subpectorally at the time of her augmentation. Upon examination to appears that she probably had a tubular component when the surgery was first performed. Postoperatively she was never completely happy. The breasts still had some residual ptosis, the nipple areola were pointy and she felt that she did not have enough volume, particularly in the lower pole. IN order to improve her appearance, having initially done a phone consultation she underwent a re-do augmentation with capsulotomy, particularly in the inferior portion where it was done in a spoke wheel fashion to allow lower pole expansion. Her implants were replaced with 500cc high profile smooth silicone followed by a periareolar mastopexy to elevate and flatted the nipple areola. Her postop recovery was uneventful. She was seen back at two weeks at which point the sutures were trimmed. Examination showed a nice correction of the tuberous appearance. Her breasts are round and full with a nicely elevated areola and no residual pointiness. She is quite pleased with her surgical outcome even at two weeks time. She knows that this will continue to improve over time.