24-35 year old female who wanted a breast augmentation. The patient was an A cup and wanted to be a D cup. This case is particularly challenging since the patient has asymmetries of the breasts in terms of size and position on the chest. The patient underwent a breast augmentation with gel implants with differential sizes. For the right breast, a larger implant was used and the breast fold was lowered to match the left breast. No breasts are perfectly symmetric but in the post-operative photos you can visualize improved symmetry.