This patient presented to me with breast asymmetry and involutional changes. She wanted to limit her scars if possible and preferred a vertical mastopexy to an anchor lift. We used implant sizers to help her decide what volume she wanted for her augmentation and confirmed this with Axis 3 three dimensional photographic simulation. We performed a breast aug,emtation in a biplanar subpectoral pocket with Allergan Style 15 implants; 286 cc for the left breast and 194 cc for the right. We also used a vertical mastopexy to shape the breasts. She was pleased with the outcome.