This 60 year old woman came to me with a few concerns. She had prior subglandular breast augmentation many years before, the left implant had a slow leak. We had no records. She didn't like the breast size or shape. We agreed on a Vertical Mastopexy technique with removal of her old implants and replacement with round smooth Mentor MPP implants. We kept them subglandular since she had adequate tissue to cover the implants. Using intra-operative temporary sizers and tailor tacking, we placed a 275cc implant in the right and 225cc implant in the left.