This is a 43 year old white female. She is 5’4” and 144lbs, which is stable for her. She had no previous surgery, but had two children via natural birth and breast fed them both. Her bra size was a 34B with second degree ptosis and large nipple/ areola complexes. She wished to be fuller though not excessively so. In order to correct this she would require a vertical mastopexy with subpectoral augmentation. We preformed external sizing to 350cc which was appropriate for her frame. She underwent an uncomplicated vertical augmentation mastopexy with subpectoral placement of the 350cc moderate plus smooth silicone prosthesis. Postoperatively she did quite well and photos obtained three months later show that the breasts are healing nicely. They are elevated with excellent nipple/ areola positioning, the areola themselves are significantly smaller and the scars will continue to improve with time. She is now able to wear clothing without a bra if desired and she is quite pleased with her result.