49-year-old with congenital condition that resulted in severe breast asymmetry and multiple previous attempts to correct it. Presented to Dr. Dumestre over 20 years after her last surgery with complaints of arm numbness and pain where the left implant had slipped into her armpit, shape and position of both breasts as well as residual asymmetry. Photos: Before; 6 months after breast implant exchange to 590cc silicone implants with 'internal bra' mesh support, repair of capsule, repair of pec muscle, lift, and fat grafting to both breasts.