19 year old with undeveloped breasts. Notice the concentration of breast tissue immediately beneath the nipple and areola, giving a pointed appearance in the oblique view. This was a patient with an undeveloped breast, difficult anatomy and a high breast fold. An inframammary fold approach was used and the existing lower breast fold was further lowered symmetrically to facilitate appropriate positioning of the implant. High profile saline implants filled to 325 cc were used on both sides and placed under the muscle using a dual plane technique. She is shown before and 6 months after surgery.