This is a 39 y.o. female 56 and 131 lbs who presents for a breast lift and augmentation. She has significant breast ptosis but does not want the traditional breast lift incisions. A peri-areolar lift is an option but is limited in the amount of lift from an incision only around the areola. She had a peri-areolar lift with 425 cc silicone implants. A verticle lift would have provided a better lift. She is seen 6 months after surgery.