This 19 year-old woman came to Minneapolis Plastic Surgery extremely embarrassed and insecure about her breast appearance. She had undergone extensive congenital heart deformity surgery at age 3, and had both sternotomy (breastbone-cutting) and right thoracotomy (between the ribs) scars. Unfortunately, the right chest scar was situated just below her right nipple at age 3, but when her breasts began to develop, this scar acted like a cheesewire that inhibited her normal breast growth on that side, leaving her with the major breast asymmetry shown in the first three photographs. A combination of dual Z-plasty right breast scar releases and sub-mammary textured-surface silicone gel breast augmentation (plus revision of her sternal heart surgery scar) improved her symmetry significantly. Her new-found confidence and self-esteem was amazing and gratifying.