This 33 year old 5′ 10″, 147 pound mother of five underwent a simultaneous breast augmentation, as well as abdominoplasty and repair of rectus diastasis and umbilical hernia. She had subpectoral 450 cc High Profile Silicone gel-filled implants. This patient had pre-operative nipple position asymmetry and did not request that this be repaired with a limited right mastopexy.