A difficult breast asymmetry case.  A 36 yo mother of 3 is shown before and after correction of a severe breast asymmetry (difference in shape and size of her breasts).  She had a pectus excavatum treated at the age of 3 with surgery to her rib cage, and has had continued chest wall asymmetry as well as left breast ptosis (drooping) and incomplete development of her right breast.  After resection of a prominent rib by the thoracic surgeon, she had a correction of her breast deformity with a periareolar (pursestring) mastopexy (breast lift) on the left, a lowering of her right breast fold by 1 cm, and placement of a 275 ml round smooth saline implant on the left, and placement of a 390 ml round smooth saline implant on the right.  Both implants were placed in a partial subpectoral postion.