This is a 27 year old healthy white female from out of town. She is 5’7” and 150lbs. She has had no previous surgery and has three children whom she was able to breast feed to a mild degree. Her bra size was a 36AB. Her desire was to be in the full C cup range. Examination showed a mild tuberous shape to the breast. There was a short nipple to inframammary fold distance with a tight lower pole and enlarged areola, but no significant herniation. After external sizing she wished to go with a larger prosthesis in the 500cc range. She underwent my standard approach for a tuberous breast case with an initial periareolar incision, aggressive release of the lower pole, dual plane augmentation and periareolar mastopexy. Postoperatively she has done beautifully. I saw her back at two weeks and as demonstrated by the photos the breasts are healing nicely. She now has a distinct lower pole, smaller and more natural appearing nipple areola and she is achieved her desired increase in bra size. The breasts will continue to soften and become even more natural in appearance over the upcoming months and all the appearances of the mild tuberous nature have been removed. She is quite happy.