55 year old patient underwent bilateral sub-pectoral breast augmentation via a peri-areolar incision using silicone gel Moderate Plus Profile breast implants with 320cc at the right and 340cc at the left. She also had an internal breast fold lift to secure the inframammary fold at a higher position as well as a small amount of peri-areolar skin removal, more from her right side than from her left for best breast size and volume symmetry and projection.