This 50 year old female disliked the sagging appearance of her breasts. Her nipple position and breast tissue fell far below her infra-mammary fold. This is the type of breast anatomy that characterizes many massive weight loss patients. She was treated with an extended Wise pattern breast lift (mastopexy) and a 345 cc smooth round silicone implant in the submuscular position. She is delighted with her lifted and more youthful post operative appearance.