This 29 year old woman had deflated breasts with good skin tone and nipples that faced forward and were positioned well above her infra-mammary creases. She initially saw another plastic surgeon who recommended saline implants, but the patient was concerned about her lack of tissue coverage and the possibility for visible rippling. She came to Minneapolis Plastic Surgery for a second opinion, and chose submuscular breast enlargement with the latest generation cohesive (“gummy bear”) silicone gel implants. She underwent outpatient surgery in our on-site accredited (AAAASF) surgical facility that took an hour under TIVA light general anesthesia. This anesthetic regimen allowed rapid wake-up, no nausea or vomiting, smooth return to light daily activities immediately, and return to the health club in 3-4 weeks. After photos show her appearance at 6 weeks post-op.