This is a 19 year old young black woman. She is 5’4” and 142lbs. She was able to lose 65lbs on her own. Her bra size is a 34A but she had a tubular component with a narrow base width and a poorly defined inferior pole. She also had first to second degree ptosis. In order to correct this she needed to be treated as a tubular breast situation through a periareolar approach; release and lowering of the crease with a biplanar augmentation and periareolar mastopexy. She was required to utilize saline implants because of her age. She underwent the above procedure utilizing 325cc moderate plus smooth saline prosthesis that were filled to 360cc bilaterally. Her postoperative course was uneventful. Photos obtained at two months show that she has had a nice improvement in the appearance of her breasts. She has more lower pole fullness with a resolution of the tuberous component. The areolas have been elevated to appropriate height while maintaining their normal diameter. Over the ensuing months the breasts will continue to soften and drop. She is quite pleased with her early postoperative results and is back to normal activities.