This is a 35 year old white female. She is 5’7” and 135lbs. She has had one child and is a competitive body builder. She presented with moderate tuberous breasts with a poorly defined inferior pole and a large nipple areola complex. Her bra size is a 34A and her desire was to be in the small to mid C range, giving her a natural appearance while wearing a bikini during her competitions. In order to correct her deformity she underwent a dual plane augmentation mammoplasty releasing the entire lower pole and lowering the crease. This allowed placement of a 350cc Mentor moderate plus smooth silicone prosthesis with the upper half beneath the pectoralis muscle and the lower filling out what should have been the lower pole of the breast. At the same time she underwent a periareolar mastopexy to diminish the large diameter of her nipple areola complex. Her photos were obtained the following day since she lived at a considerable distance. They show that the essential goals have been nicely achieved. The breasts are symmetric and round with a nice enhancement of the lower pole, the nipple areola complex is smaller and at the same height. Over the next several months the breasts will soften and take on a less tight and round appearance.