We describe a technique for the correction of ptotic and hypoplastic breasts that combines the vertical scar technique with the insertion of a subpectoral saline implant. This operation consists of a vertical elliptical skin incision through which we make a subpectoral pocket, insert a smooth surface implant, sit the patient up, and mark a new nipple placement. We then remove a wedge of breast tissue above the areola to position it at the marked spot. This simple technique has few complications and a high level of patient satisfaction.