Mastopexy and augmentation together can be a very difficult combination of procedures to perform. In many cases, the position of the implant can be inappropriate, necessitating reoperation. Occasionally, placing the implant imparts excessive tension, which can cause a plethora of complications from simply widening the scars to skin necrosis, nipple-areolar necrosis, or glandular necrosis with infection and loss of the implant. In this paper, the author presents a technique combining the vertical mastopexy, a superior nipple-areolar pedicle, and the use of the Spectrum postoperatively-adjustable implant which can simplify the procedure and minimize complications related to implant tension.