This is a healthy 23 year old white female. She is 5’4” and 125lbs. She had no history of previous surgery. Her bra size was a 34B with asymmetry. The left breast was smaller and the inframammory crease was positioned approximately 2.0cm higher than the right. In order to correct her problem she would require differential augmentation with lowering of left inframammory fold crease. After external sixing, she decided on a saline prosthesis in the 450cc range. With this in mind she underwent bilateral differential augmentation with a 425cc moderate plus smooth saline prosthesis filled to 450cc on the right and a 450cc moderate plus smooth saline prosthesis filled to 480cc on the left. Her postoperative course was unremarkable and photos taken two months postoperatively show that she has achieved her desired result. The breasts are full and symmetric and the inframammory fold creases are now properly aligned. She is back to all normal activities and is quite pleased with her result.