This woman came to me wanting to change the volume and the shape of her breasts. I recommended a vertical mastopexy to create the shape of her breasts and she chose about 450 cc of augmentation with breast implant sizers. Though her breast shapes were clearly different, the volumes were quite close to each other. We performed a biplanar subpectoral breast augmentation using Allergan Natrelle style 20-450 implants while simultaneously performing a vertical mastopexy. She had an uncomplicated recovery and was very pleased with the outcome.