This 28-year-old patient that presented with grade II ptosis bilaterally (nipple below the inframammary fold) and desire to be into a good D cup. This requires a placement of a larger implant and the challenge in breast lift with an implant is to keep the implants “uphill” with tissue that is stretched and non-supportive. We used an Allergan style SCM gummy bear silicone gel implant 445cc bilaterally and then performed a Brazilian lift on top of that. Care was taken to retain some supportive tissue beneath the implant and then postoperatively we locked her into a Victoria’s Secret knockout bra, which is our go to support to hold implants in place. Her results as seen almost one year later, with her breasts still up off her tummy!