19 year old female who presented to discuss the possibility of bilateral breast augmentation. She lives about 4 hours away, but was impressed with our other work on friends of hers that she opted to travel to see us for this. She is not married and has no children. She states that she has had an issue with symmetry her entire life. In her opinion her left breast is “normal” and the right breast has always been so much smaller. She has been very self conscious about this issue since she can remember. She states that she has done significant research on augmentation and is ready for this deformity to be corrected or at leat improved. Her goal at her initial visit was to determine what type of implant is best and how this procedure will aid in correcting her individualized issue. Height is 5’5. Weight is 130. After trying on our sizers, she decided that her goal was around 400 cc. Therefore, she underwent bilateral breast augmentation; subpectoral: smooth round high profile silicone gel implants (400cc right dual plane, 350cc left) using an inframammary incision and a dual plane approach to minimize the risk of a ‘double bubble’ deformity. The procedure was performed in-office in our fully accredited (AAAASF) facility under light sedation and local anesthesia. Results are shown at 3 months. It should be noted that the FDA limits silicone gel implants to women over 22 years of age in general. However when the issue is to correct a congenital the former the, such as in this case (asymmetry) the user silicone gel implants is permitted and is not “off-label”.