Numerous techniques for correction of mammary ptosis are described to provide a well contoured breast with minimal scars. However, the majority of women requiring mastopexy require some degree of volume augmentation to compensate for mammary atrophy. The concept of a single stage mastopexy with prosthetic implant augmentation is an attractive concept, but is known to have higher rates of complications compared to either procedure alone. Furthermore, superior pole fullness is usually lacking in majority of patients undergoing this procedure. Utilizing autologous fat grafting as a means of augmenting volume, creating an attractive cleavage and providing superior pole fullness to the breasts at the time of mastopexy is a viable alternative. A retrospective review of 70 autologous fat transfers to the breast in 36 patients from October 2006 to October 2008 was performed. Pre- and postoperatively photography and mammography were performed to monitor the stability of breast size, shape and contour and also to detect mammographic abnormalities. The mean follow-up period of patients was 12 months. With the exception of one patient, all patients with postoperative mammograms were clear of any abnormalities with respect to preoperative mammograms. Patient and surgeon satisfaction with the outcomes of the procedure and photographic evidence of viability and stability of breast size were used to gage final outcomes. All women had a significant improvement in their breast size and shape postoperatively and all had breasts that were soft and natural in feel and appearance. Mean operative time of implant removal and fat grafting to the breast was 183 minutes. Single staged mastopexy with autologous fat grafting to correct changes associated with breast ptosis with restoration of volume is an alternative in rejuvenation of the breast. This single staged technique provides superior pole fullness of the breast and an attractive cleavage without disturbing the circulation to the breast and the architecture of the breast. Therefore, it reduces the rates of complications seen with mastopexy and simultaneous implant augmentation.