This is a 45 year old healthy white female. She is 5’4” and 125lbs. She has had three children via c-section. She is a non-smoker and recently lost 20lbs. Her bra size is a 34B with second degree ptosis. She desired to be just a bit fuller and to have the breast replaced to their pre-pregnancy position. In order to achieve her goal she underwent a subpectoral augmentation with a 200cc moderate smooth saline implant filled to 230cc bilaterally and a vertical mastopexy. Her postoperative course was unremarkable. Two months following surgery she has already begun to heal nicely. The breasts are fuller and lifted particularly in the superior pole region without significant enlargement. They are natural, soft and the scars will continue to fade over the upcoming months. She is back to all normal activity and quite pleased with her surgical outcome.