This patient came to see Dr. Daniel after having breast-fed five children. She wanted to go as large as possible and clearly needed a breast lift as well. She had been a half pack per day smoker. Dr. Daniel requires all of his mastopexy (breast lift) patients to be nicotine free for at least a month so that the tissues can more predictably heal without the negative effects of nicotine. Preop nicotine testing verified that she had quit smoking. As such, a “vertical bipedicle mastopexy” was performed using fairly substantially sized retropectoral implants (533 cc on the right and 575 cc on the left). Her postop photographs show that her scars have not fully matured, but there is substantial improvement in nipple position, contour and volume. Dr. Daniel and the patient are both very happy with the changes. (Close inspection of her right breast vertical incision shows a scratch from the patient’s fingernail that is unrelated to surgical healing).