This 26-year-old female desired breast augmentation. After careful examination, Dr. Steele determined that she had a mild constriction of the lower breast with early ptosis. In order to allow for lower breast expansion and optimal control of the nipple position relative to the implant, a peri-areolar mastopexy was performed in combination with placement of submuscular silicone gel-filled implants. She is very pleased with her new size and improved shape at 3 months.