This is a 61 year old woman with a deflated breast implant and breast ptosis after a breast augmentation 25 years ago. On exam her left breast was dramatically smaller than her right. She liked the look of her breasts but wanted to replace her deflated implant and better match the volume of the left breast to the right breast. She underwent an asymmetric dual plane breast augmentation with silicone implants. She did very well after surgery with minimal bruising and swelling. At 1 month after surgery, her breasts have settled to a natural but perky shape and her scars are maturing well.