This is a 25 year old healthy white female with no previous surgery. She is a non-smoker. She is 5’3” and 120lbs. Her bra size was a 34A with a tuberous component, more so on the left than the right. She had herniation of the nipple areola, but not an overly constricted lower pole. Since she lacked much in the way of breast tissue to correct her abnormality and asymmetry she would be approached as a full tuberous case with a release and creation of the lower pole, dual-plane augmentation and periareolar mastopexy. Her desire was not to be much larger in size but to have a more natural appearing breast shape. That being the case, having done external sizing she chose implants in the low to mid 200cc range and underwent the tuberous correction utilizing a 250cc moderate plus smooth silicone implant on the right and a 225cc implant on the left with standard release and periareolar mastopexy. Her postoperative course was completely unremarkable and two months after surgery she is healing beautifully. The breasts are round, symmetric, she no longer has the small nubbin tuberous areola and the scars are settling in quite nicely. She is ecstatic with her surgical outcome with improved self-confidence and self-esteem.