This is 23 year old healthy white female with no history of previous surgery. She is 5’5” and 140lbs. Her bra size was a 34A with a tuberous component and deficient lower pole. The nipple areolas are also situated in a slightly lateral position. She had mild asymmetry. Her desire was to be as full as reasonably possible in the C cup range. She was from out of town and knew that she would need to stay in the area for two days. She came in the day before surgery and underwent external sizing and a 400 and 425cc moderate plus implants were chosen. In order to correct her tuberous deformity she underwent bilateral dual plane augmentation though a periareolar approach with significant release of the very tight lower pole. Utilizing a Keller Funnel a 400cc moderate plus smooth saline implant was placed on the right and a 425cc was placed on the left. She then underwent a bilateral periareolar mastopexy to elevate the nipple slightly and diminish the puffy appearance. She returned home the day following surgery and photos obtained at two weeks, when she returned for suture trimming shows the early appearance of a tuberous breast reconstruction. She now has fullness and the lower pole has been markedly improved without any risk of a double bubble. The nipple areolas are properly situated on the breast mound. She has no pain, she is back at work and quite pleased with her result knowing that this will continue to improve and settle over the coming months.