This is one of Dr. Hughes’s many breast reconstruction patients. Dr. Hughes performed fat grafting in this patient who had chest wall surgeries in the past to correct chest wall defects. Some of the remaining defects were improved with creative fat grafting techniques. The shape and size were both improved. Some of the chest wall abnormalities were camouflaged as well. The patient did not want breast augmentation with implants. Breast augmentation with fat grafting can only achieve 3/4 cup increase in size, and it is very important that patients realize and understand this limitation. If more projection or size is desired, breast implants must be considered.