This 21 year old woman wanted breast augmentation with the newest generation of cohesive silicone gel implants despite being younger than the FDA-recommended 22 years of age. She came to Minneapolis Plastic Surgery because she knew we understand that it is not only legal but perfectly appropriate for a properly-informed woman under the age 22 to request breast enlargement using silicone implants “off-label.” She had submuscular placement of silicone gel implants in our nationally-accredited (AAAASF) office surgical facility. Five months after her initial surgery she requested adjustment in implant position to improve a mild symmastia and crease symmetry (no surgeon’s fee; facility and anesthesia costs only). Her after photos show her appearance 3 months after her revisionary surgery, including brassiere photos that show complete correction of symmastia (normal cleavage even wearing a bra). She continued to do well one year later, indicating long-term correction.