This parient presented to me wanting to improve the appearance of her breasts. She demostrated ptosis and asymmetry. I recommended a vertcal mastopexy with implants to correct her asymmetry. Volume was chosen with the use of sizers and the planned outcome was evaluated with the Vectra photographic simulation system . She underwent augmentation with Allergan Natrelle Aspira implants, SRM-445 for the left and SRM-405 for the right, as well as a vertical mastopexy. She was pleased with the result.