This is a 22 year old healthy young woman, whom I initially spoke to when she was 20 years old. She is 5’3”, 120lbs and a non-smoker. Her bra size was a 32B, but unfortunately she had a severe tuberous breast deformity with large herniated nipple areola. After an extended phone consultation she decided to travel to the United States where examination confirmed the severe deformity. The areola themselves encompassed the majority of her breast as well as having a marked constricted nature. In order to diminish the areola size a vertical component would be necessary as part of the release and augmentation mastopexy. She decided to proceed knowing that she would need to stay in the States for 8 days. She underwent the tuberous correction, release of the lower pole, dual-plane augmentation utilizing a 275cc moderate plus smooth silicone implant combined with a vertical mastopexy. Postoperatively she has done quite well. At one week the interrupted sutures were removed and the steri-strips were changed. At this point in time the breasts are doing quite well. They are symmetric, the superior fullness which is present in the early postoperative phase will resolve over the next one to two months. She has a nice release of the lower pole and a much smaller nipple areola. The bruising from the release will continue to fade over the next week or two. Her results show that even a severe tuberous deformity can be corrected in a single stage. She is quite pleased, has returned to her country and knows that she can resume all normal activity within a month or two.