*This 51 year old woman had been previously treated for a congenital defect called Poland’s syndrome. Poland’s syndrome is a condition that results in a small breast and absence of the pectoralis muscle. She had a breast implant placed thirty some years ago to decrease her breast asymmetry. Her implant had now ruptured and she had a hard capsule around it. Concurrently her asymmetry was still apparent. Her surgeon developed a plan. The plan included removal of the ruptured implant and capsule with insertion of a new gel implant. A breast lift would be done to the opposite breast to help achieve symmetry. This was stage one. One year later fat (145 cc) was added to the superior aspect of the left breast to reduce the “step off” between the implant and the superior aspect of the chest wall. This softened the contour but one more session of fat grafting was needed to compete the reconstruction. Five months later 100 cc additional fat was added again to the superior pole of the breast. Her final result shows her at six months after her final procedure with a very nice resolve to her breast asymmetry.