This 41 year old patient presented to Dr. Siamak Agha for a Breast Augmentation with silicone implants. The patient desired larger, fuller breasts and chose to have breast enlargement surgery to achieve her desired results. Upon examination, Dr. Agha noted that the patient’s breasts lacked fullness and projection and planned a Breast Augmentation with the patient. Dr. Agha began the procedure by creating incisions under each breast inside of the mammary folds. Then, he created a pocket under the patient’s breast muscle. The patient, under the advisement of Dr. Agha, chose to have her implants placed under the muscle rather than above the muscle. There are benefits and draw backs to each approach, and it is a personal decision. One factor to consider is that placing the implant below the muscle decreases the risk of capsular contracture. Putting the implant below the muscle also provides a more natural breast contour, especially for patient’s who have very little breast tissue or fat to begin with. However, placing the implant above the muscle can often provide a more lifted appearance to those who’s natural breasts sag. Breast Augmentation surgery with over the muscle implants also has an easier recovery than Breast Augmentation surgery with under the muscle implants. Ultimately this patient chose to have her implants placed below her pectoral muscle. After her Breast Augmentation Surgery with round smooth 400 cc silicone implants, the patient had much fuller, more projected breasts. The patient’s Breast Augmentation before and after photos were taken 5 months after her procedure and she was very happy with her results.