This patient came to me with a history of subglandular breast augmenatation with gel implants and a cresent lift. She was displeased with her result as her implant position was too low with a discrete step off above the implants. We kept the size the same at 300 cc, but placed the implants in a biplanar subpectoral position, tightenng the lower pole. We proceded with a vertical astopexy but found that there was too much distance between the areola ad the inframmmary fold, so we had to convert her skin removal to a narrow anchor lift. She was pleased with the outcome.