32 year old female, had original breast augmentation over 10 years ago with a different surgeon. Dislikes the asymmetric appearance and drooping of the breasts and desires a more perkier appearance. A breast augmentation revision was performed with removal of her previous implant and replacement with 485cc full profile silicone. Additionally a peri-areolar lift (donut lift) was performed to reduce the size of the areola as well as provide her with more perkiness. Results show a significant improvement in breast fullness, perkiness, breast shape, symmetry, nipple position and size.