This lady wished to increase the volume of her breasts. She has asymmetry and the nipple on the left sits lower than the right preoperatively. The decision between implants and mastopexy implant in a patient such as this is very complex. Patients must be aware of the pros and cons of each technique and be shown examples of each option. Patients must make an informed decision as to how to proceed. The post op images are seen weeks after and years later.