This 31 year old woman lost much of her breast fullness, as well as developing grade 2-borderline grade3 ptosis (droop) after breast feeding two children. She came to Minneapolis Plastic Surgery for breast enlargement, hoping to avoid the scars and cost of a breast lift. Even though her consultation was several years after the FDA again released silicone gel implants for use in first-time cosmetic breast augmentation, she requested saline filled breast implants. She was also hopeful that breast enlargement would improve her left nipple inversion. She underwent outpatient submuscular saline implant placement in our AAAASF accredited office surgical facility, one of very few private plastic surgical practices that feature on-site surgical centers with full anesthesia capabilities. Her surgery took just under an hour, and her recovery was rapid and nausea-free, largely due to our TIVA anesthesia skills. Her after photos are shown at 6 months post-op.