This 27 year-old patient has had one child, and has heavy, pendulous breasts with grade III (severe) ptosis (breast droop). She requires full Wise pattern (anchor pattern) mastopexy to tighten and lift her skin brassiere while maintaining breast size without implants. Outpatient surgery was performed at Minneapolis Plastic Surgery in our accredited surgical facility. Surgery took about 3 hours; after an hour in the recovery room, she was awake, alert, non-nauseated, and ready for discharge, due largely to our skilled anesthesia providers and TIVA general anesthesia that does not have the gassy smell, dizziness, and slow wake-up that inhalation (gas) anesthesia techniques typically require. Note her scar appearance at 7 weeks post-op–dark skin can be associated with thicker or more pigmented scars. However, precise and careful closure with under-the-skin dissolving sutures only can yield the best results possible regardless of skin type.