This is a 51 year old; height is 5’6 1/2” & weight 120 pounds. She has 3 children and was requesting breast implants to help restore lost volume and shape. She is seen here 3 months after a sub-muscular augmentation mammoplasty using 421 ml smooth, round moderate profile silicone gel implants through an inframammary fold approach. Her bra size went from 34A to 34D. Please note that the patient has moderate looseness and ptosis of her breast skin; we were on “the fence” on weather we should do a lift at the same time of the augmentation. Turns out we opted notto perform a breast lift at the time of her augmentation and she is happy with her results. Having said that, as time passes, she will likely need a vertical mastopexy (lollipop breast lift) to help lift, tighten & reshape her breasts. In her case, a staged mastopexy is easily done with light sedation and local anesthesia.