This woman in her early 20s had been thinking about breast surgery for some time, and had gone on several consultations over more than a year. She came to our Scottsdale office and said, "I would like fuller breasts and I would like my areolas to be more symmetrical." She had one child, and lost breast volume with the pregnancy. Because the problem was more areolar size and enlargement rather than breast drooping, Dr. Nachbar performed a Circumareolar (Donut) Mastopexy / Breast Lift along with Breast Augmentation using a 375 cc cohesive silicone gel breast implant placed under the muscle using the mastopexy approach. She is shown three years later, has added nipple piercing since the surgery, and her scars have faded nicely in spite of her pink skin.