Congenital breast deformities pose a challenging dilemma in plastic surgery. The expression of the abnormality maybe complete, and anatomic components are often missing, deformed, or weakened. Most breasts are naturally asymmetrical. These asymmetries may include discrepancies in breast size and shape, location of the nipple-areola complex, the inframammary fold, or skeletal abnormalities (see Figure 29.1). Breast abnormalities can cause emotional and psychological trauma, resulting in social maladjustment and associated behavioral problems. The majority of patients are young healthy individuals who seek aesthetic restoration of their deformities.