The patient is a 49-year-old female who presented to my office with complaints of breast size smaller than desired. She was also noted to have low-set nipple-areola complexes with the left side being worse than the right. I felt a bilateral breast augmentation with circumareolar mastopexies would give the patient the best overall results. During surgery I placed Sientra 275cc textured classic anatomical moderate profile cohesive silicone gel implants and performed circumareolar mastopexies to shift the nipples into a more central location on the breasts. The patient reovered well and was very happy with her improved shape and fullness.