This 21 year-old woman told us she has always been bothered by her small, unattractive breasts. She underwent augmentation mammoplasty at Minneapolis Plastic Surgery’s AAAASF-accredited on-site surgical facility, and had 575cc silicone gel implants (cohesive latest-generation) placed below her pectoralis muscles in a 50-minute operation. Use of silicone gel implants in a woman under age 22 is perfectly legal and appropriate as long as informed consent regarding “off-label” use is obtained, and the patient requests their use. Her TIVA anesthesia allowed her to leave the facility in 1 hour feeling comfortable and relaxed without nausea or that bloated, gassy, dizzy, inhalation anesthesia smell (and higher nausea risk). After photo at 1 year post-op.