This is a 22 year old healthy young female. She is 5’3” and 126lbs. She’s had no previous surgery and is a non-smoker. Her bra size was a 36A and she presented with a true tuberous deformity. The breasts are narrow with a tight inframammary fold and large herniated areola. I initially saw her when she was 21, but advised waiting until the age of 22 so that she would be eligible for silicone implants. In order to correct her deformity she required a traditional periareolar approach, release of the lower pole, dual-plane augmentation and periareolar mastopexy. We did external sizing and she chose a 350cc moderate plus smooth silicone implant to give her a nice C cup bra size. Her surgical procedure was unremarkable. She returned home after two days and early follow up photos at two weeks shows that we have obtained the desired result. The breasts are now round and natural appearing with a much smaller areola with the removal of the herniation. She is delighted with her surgical outcome and knows that the breasts will continue to soften over the upcoming months.