A 23-year-old lady from Scottsdale, Arizona was self-conscious about her small 34 A breasts and desired to achieve a D cup. She had some obvious asymmetry before surgery and different breast implant sizes were recommended to improve has symmetry. At 5 feet 10 inches and 158 pounds, she wanted bigger breasts without being too big, but was comfortable with a D cup. We used a 450 cc smooth Moderate Plus silicone gel breast implant on the smaller right breast and a 425 cc implant on the larger left breast. Both were placed via the crease incision and under the muscle. After surgery, she demonstrates improved symmetry. She can wear a 34 D or a 32 DD and loves her result.