A 23-year-old woman requested a significant breast augmentation with silicone breast implants. Wearing a B cup most of her life, she considered her breasts small for her 5 feet 7 inches and 133 pound body. She wanted a full D, that would stand out, but not be considered "way too big" and to improve the asymmetry as her left breast which was slightly smaller when compared to the right side. Her left shoulder was also mildly elevated. Placing both moderate plus implants via a crease incision and under the muscle pocket, the right breast received a 475 cc silicone breast implant and the left a 500 cc silicone implant. Her after photos show her 3 months after surgery.