32 year old female, had original breast augmentation over 10 years ago with a different surgeon. Dislikes the asymmetric and dropping appearance. A breast augmentation revision was performed with removal of her previous implant and replacement with 485cc full profile silicone. Capsulorrhaphy (pocket manipulation) was done to reposition the implants correctly. Additionally a peri-areolar lift (donut lift) was performed to reduce the size of the areola as well as provide her with a lift for more perkiness. Results show a significant improvement in breast fullness, perkiness, symmetry, breast shape, nipple position and size.