This is a 42 year old female that desired breast enhancement with the most natural appearance. She underwent subpectoral breast augmentation (under the muscle) with textured, form-stable cohesive “anatomic” Sientra 450 cc silicone gel implants. 1 year follow up pictures are shown with a natural slope in the upper pole of the breast and stable position of the breast implant on the chest wall and no changes to the implant position.