This is a 23 year old woman with lifelong breast asymmetry who had undergone previous breast surgery by another plastic surgeon. Her left breast was much smaller than the right and she undergone reconstruction with different-sized saline breast implants placed below the chest wall muscle. She was bothered by the enlarged right areola (pigmented tissue around the nipple) and the double bubble appearance of the breasts particularly prominent on oblique and lateral views. On the right side, Dr. Jejurikar removed her saline implant and converted it to a 234 cc silicone gel implant placed in front of the chest wall muscle; Dr. J also narrowed the diameter of the right areola. On the left side, Dr. Jejurikar removed her saline implant and converted it to 457 cc silicone gel implant placed in front of the chest wall muscle. Three months after surgery, she has a similar appearance of the areolas and has a much more symmetric appearance.