27-year old female complains of small, empty and saggy breasts that have been present since pregnancy – 5’6“ tall, weight 125 lb.- bra size 32 B. She wanted breasts that are full and natural. The patient had asymmetry of the costochondral elements of the ribs and chest wall. The left chest is more anterior (ventral) than the right chest. The patient understands some asymmetry will remain, even after the augmentation. On physical examination, there is evidence of bilateral mammary atrophy, Grade I mammary ptosis, breast striae and breast/rib asymmetries. The right breast is slightly wider than the left breast, but the left breast has more sag. The breast augmentation was performed with Allergan Style 410 shaped “gummy bear” highly cohesive silicone gel breast implants placed in the submammary position (above the muscle), with different implant sizes of 450 cc on the right and 410 cc on the left to correct the breast and rib asymmetries. Bra Size is now — 32 DDD — which is the size the patient desired. She is happy she did not have to have a lift, as the breast implants create a natural lift, without the scars of a full mastopexy.