This Caucasian female chose a transumbilical approach for breast augmentation (through the belly button). Notice the absence of scars on the breast. A submuscular approach was chosen to give a more natural takeoff at the superior aspect of the implant and to provide better camouflage for the implant. She opted for saline augmentation with 425 ml implants. Dr. Hughes created a result that is natural and symmetric despite the constricted nature of the breasts and the marked asymmetry that existed preoperatively. The patient was very happy with the result.