This 26 year old woman from St. Paul went to Miami for a “super low-price” breast augmentation. The surgeon there chose ultra high profile 420cc silicone gel implants (11.75cm base with 5.9cm projection), and placed them in a position that perhaps looked good for a few weeks or months, but ultimately bottomed out severely (as well as dropping into her right armpit when reclining). She came to Minneapolis Plastic Surgery where she had internal pocket work (capsulorrhaphies) through her previous (too low ) scars to improve her implant position. We would have preferred higher initial incision placement (but chose to use her poorly-placed old scars rather than give her additional incisions and new scars), and also would have recommended less high profile (wider base) implants for improved cleavage. The patient chose to keep her previous implants, which yield her rounded, less natural (but significantly better-positioned) appearance. Her post-op photos show maintenance of better position 4 months after surgery.