38 yr old, 6’1” presenting with asymmetry of the breast and a tubular breast presentation. She had two kids and was unable to breast feed due to little to no milk production. She underwent submuscular placement of saline implants 625cc L and 650cc R with scoring of the breast tissue to allow it to open up to the implant and a circumferential incision around the areola to shape and tighten that as well.