This 36 year old patient had changes and volume loss to her breast after children and breast feeding. She wanted very natural volume restoration but was very fearful about breast lift incisions, even though I had initially counselled her she would probably need a breast lift with implants. She is very tall and has very “low lying breasts” on her chest wall with a more prominent, wide, and angulated rib cage (costal margin). Even a breast lift doesn’t change the position of the inframammary crease (crease under the breast) which I think is important to point out to patients. It simply changes the position of the nipple relative to the inframammary crease. In trying to meet this patient’s precise goals and wishes, I recommended dual-plane subpectoral breast augmentation with smooth round silicone gel breast implants in order to get some degree of internal “lift effect”. Shown is her three month after pictures with natural volume restoration of the breast as well as improvement in the scalloping (concavity) in the upper pole of the breast. She also has some internal “lift” effect to the nipple from the dual-plane technique without external breast lift incisions.