This is a 22 year old white female. She is 5’4”, 120lbs and has long been concerned about her breasts. She demonstrated a tubular deformity with slight asymmetry. The right breast was slightly larger than the left with some mild herniation and a tight poorly defined lower pole. She had seen several other physicians for correction, but was not completely happy with their recommendations. Having discussed all of the risks and benefits she decided to proceed and underwent a bilateral dual plane differential augmentation with a 325cc moderate plus smooth silicone implant on the left and a 300cc implant on the right along with a periareolar mastopexy. Her postoperative course was uneventful. Three months later things have settled in nicely. She now has normal appearing breasts with good lower pole fullness. She is back to all normal activity and is quite pleased that she can wear any type of clothing that she desires.