This 21 year old woman wore A-cup bras (B at VS), and always wanted C-cup breasts (D at VS). She came to Minneapolis Plastic Surgery for submuscular cohesive silicone gel breast implants (not saline), and had the confidentiality of our on-site, nationally accredited (AAAASF), outpatient surgical facility with full anesthesia services. Silicone implants are perfectly legal and appropriate for informed women under the age of 22 who request their use and understand they are being used “off-label.” Her procedure included TIVA (Total IntraVenous Anesthesia) administered by experienced CRNAs, not MD anesthesiologists who often supervise without being in the operating room. (Our CRNAs remain in the OR for the entire operation, and both of our surgeons, as well as anesthesia providers and recovery room RNs, are all ACLS–Advance Cardiac Life Support–trained.) Safety is our first priority; comfort and rapid recovery without the nausea and vomiting of gas anesthesia is our next concern, as well as giving you a superior result. This patient’s after photos show her results at 2 years post-op.