Description: To achieve the optimal outcome in cases with severe breast asymmetry, simultaneous breast reduction and augmentation is occasionally necessary. This patient had her larger left breast reduced using an anchor scar pattern of skin excision. Nipple vascularity was preserved using an inferior pedicle. A moderate quantity of breast was excised (608g). The contralateral smaller right breast was augmented with an anatomical silicone gel implant (515 ml) to achieve symmetry. Photographic documentation was obtained at 10 weeks following surgery. Note that surgical cases of Dr. Chen Lee are presented for illustrative and educational purposes only. These illustrative cases should not be construed as a guarantee nor assurance as to the surgical results attainable by prospective patients.