This is a 31 year-old female who presented to the office requesting bilateral breast implants with a lift. The patient had a pre-existing breast asymmetry with the left breast being significantly larger than the right. We did Crisalix imaging in the office to determine her ideal implant size and shape. She decided on bilateral 325 cc Mentor Smooth Round Moderate Plus Profile Xtra Silicone Breast Implants. The Crisalix imaging software also measured her size asymmetry at 150 ccs with the left breast being larger. We performed a bilateral breast augmentation with Mentor Smooth Round Moderate Plus Profile Xtra Silicone 325 ccs implants with the implants placed in the submuscular position via a periareolar incision. The surgery was completed under general anesthesia at our office-based AAAASF accredited surgical facility in Downers Grove, IL. On the right side, we did a circumvertical mastopexy to lift the right breast. On the left side we did a circumvertical mastopexy with a 130 gram breast reduction to restore the size symmetry. Exparel was injected around both breasts at completion of the procedure for better postoperative pain control. At three months postop, the patient has symmetrical breasts in terms of size, an increase in size, and an improvement in breast position secondary to the lift. Notice the incisional redness is mild at 3 months and will continue to improve over time. The patient is using silicone sheets for postoperative scar management.