This patient presented with loss of breast volume. She had bilateral breast augmentation with Mentor Smooth Round High Profile 500 ccs Silicone Breast Implants placed via a periareolar incision in the submuscular position. We used Exparel for postoperative pain control and the implant was placed with a Keller funnel. The patient refused a periareolar lift at the first procedure but opted to the lift as a secondary procedure.