This patient came to me with the desire for larger and symmetric breasts. Our first operation involved a right sided vertical mastopexy with bilateral saline implants in a biplanar subpectoral position. Her recovery was marred by an implant deflation and she wanted both to use gel implants and to increase the size. We maintained the integrity of her existing lift and used Allergan Natrelle implants style 20. 650 cc for the left and 600 cc for the right. She was pleased with the eventual outcome of her breast augmentation.