This is a 26 year old healthy young woman with no previous surgery. She is 5’8” and 124lbs. Who presented with asymmetric tuberous breasts from out of town. The breasts were small with a short nipple to inframammary fold distance and constricted with a prominent nipple areola complex. Her bra size was a 34A and she wished to be in the full C range. After an initial phone consultation she decided to proceed and knew she would need to stay in the area for approximately one week. The following day she underwent a standard approach though a periareolar incision, release of the lower pole, dual-plane augmentation and periareolar mastopexy. I was able to elevate the right nipple areola without resorting to a vertical component. Her postoperative course was uneventful. At one week we changed the steri-strips. Examination showed excellent symmetry. She has achieved her desired size. The tuberous component has been removed and she is quite pleased with her surgical outcome, knowing that over the ensuing months the breasts will get even more nature in appearance and shape. She will be back to all normal activities within a month.