This 18 year old woman came to Minneapolis Plastic Surgery for breast augmentation, but after extensive research, wanted the latest generation of cohesive silicone gel implants rather than saline ones. She requested “off-label” use of silicone implants, which is perfectly legal, ethical, and appropriate for informed women who request their use. She underwent breast enlargement with submuscular silicone implants placed in a one-hour outpatient operation in our nationally accredited (AAAASF) office surgical facility. Her recovery was rapid and with minimal discomfort, and she returned to school, work, and activities in several days, and exercise in several weeks. After photos are at 4 months post-op.