This is a 32-year-old female who desired better appearance to her breasts, rather than flattened and ptotic and deflated after pregnancy, she desired more youthful and perky breast appearance. We achieved this with a small breast reduction and elevation using a vertical mastopexy technique. Implants placed were highly cohesive moderate projection silicone gel implants from Sientra 440 cc. Therse were placed in the subglandular position. She is much more confident in her appearance, able to participate in athletic endeavors without difficulty. She went from a D cup to a double D cup with her procedure. She also had concurrent liposuction, 360 degree which gave her a much more elegant physique.