The lower positioned areolas pose a dilemma for both the plastic surgeon and the woman. Especially if the woman had not noticed it before the breast augmentation consultation. The decision for a breast lift is typically based in part by position of the areola on the breast mound. The high positioned areolas allow for the breast to be enhanced using just breast implants.The extremely low positioned areolas require a breast lift. The tough decision is when the areolar positions are ‘on the border’ and there is a choice to lift the breasts and areolaes or just place breast implants. These woman have to decide, breast lift or not. This section exemplifies women who were given the choice and elected to have only breast implants placed. These results demonstrate a lower breast mound but still have very happy women. None of the women with these breast augmentation results requested breast lift cosmetic surgery after their surgery.