This is a 28 year old healthy white female. She is 5’5” and 135lbs. She lost 100lbs on her own through diet and exercise. She is a non-smoker. Due to the weight loss she had developed a glandular ptosis with the lower pole sitting on her rib cage. Her bra size was a 34AB and she wished to be in that full C range. She also greatly wished to avoid the vertical mastopexy incision. Her base width was 14.0cm and she had first to borderline second degree ptosis. Having discussed the surgical options at great length she chose to proceed with the dual plane augmentation and periareolar mastopexy with differential augmentation for the slight asymmetry of the left breast, which was a bit larger. She underwent an uncomplicated dual plane augmentation with an aggressive periareolar mastopexy to remove as much skin as possible, particularly on the lower pole area without resorting to the vertical component. A 425cc moderate plus implant was used on the right and a 400cc moderate plus implant was place on the left. Since she was out of town she spent the night and her postoperative course was uneventful. Photos obtained at two months show that the breasts are healing well, including the periareolar incision. The breasts are full, they have been elevated and they no longer sit on her chest wall. She is back to normal activities and is quite pleased with her surgical outcome.