An interactive video from the 45th Annual Baker Gordon Symposium on Cosmetic Surgery, held February 10–12, 2011, in Miami, Florida, is presented. Breast augmentation with autologous fat offers an ideal opportunity to sculpt and shape the breast. In this four-part surgery video, Roger K. Khouri and his team augment and correct the tuberous breast deformity of a young woman who had expanded her breasts with Brava for 4 weeks prior to the procedure. They harvested the fat with a controlled low-pressure vacuum syringe and after minimally manipulating it, they reinjected it diffusely until tumescence. They then percutanously released the congenital constriction and lowered the inframammary fold by performing staggered slits that mesh expanded the tissue and created micro alveoli where the graft can survive. Without any incision they lowered the inframammary fold and achieved an aesthetically pleasing over 250 ml AFT breast augmentation.