This 25 year old teacher from North Dakota came to Minneapolis Plastic Surgery for breast enlargement. She understood that fat grafting could interfere with mammography and breast cancer detection, and therefore requested cohesive (often called “gummy bear”) silicone implants below her muscles, allowing full self-exam, mammography, and physician evaluations, as well as preserving nipple sensation and ability to breast feed in a majority of patients. Her outpatient breast augmentation took just 1 hour, and she left our recovery room in 65 minutes, due mainly to her TIVA anesthesia. She was seen in recheck the following morning, after which she was seen at week 1, 2, 6, and 16 weeks. Her after photos show her appearance at 4 months post-op; further softening and settling occurred up till one year post-op.