This is a healthy 19 year old young woman who had no previous surgery. She is 5’3” and 120lbs. Her bra size was a 34A with asymmetry. The breasts themselves were also tuberous in nature. The right had a tight inferior pole with a protuberant nipple areola complex. The left was markedly deficient in tissue with no lower pole at all. She had traveled to see me from another state and we discussed at length the techniques needed to correct her tuberous condition. On both sides a dual plane augmentation was necessary with release of the lower pole and a right periareolar mastopexy to diminish the herniation in the nipple areola complex. She also would require differential augmentation because of the significant asymmetry. Due to her age she was required to use saline implants. She decided to proceed and underwent bilateral dual plane augmentation with a right periareolar mastopexy. On the right side we used a 250cc moderate smooth saline prosthesis that was filled to 310cc. On the left we used a 300cc moderate plus smooth saline prosthesis that was filled to 350cc. Her postoperative course was unremarkable. Two months later she is completely healed. The breasts are symmetric, natural in appearance and no longer have any signs of a tuberous deformity. Her personal self-esteem has been greatly enhanced. She is wearing normal clothing for the first time.