During a 2-year period, we performed a single-stage procedure on 7 patients with unilateral "tuberous" breasts after thorough analysis of the deformity and the contralateral breast. Deficient breast envelope skin was replaced by use of a laterally based random inframammary cutaneous flap. Breast tissue rearrangement with or without augmentation was required to address the parenchymal maldistribution and volume abnormalities. Associated tuberous breast ptosis was adequately corrected by tissue rearrangement, augmentation, and circumareolar mastopexy. Areola herniation and size were adjusted by performing a circumareolar mastopexy. Relocation of the inframammary crease was necessary to achieve symmetry. There were two complications in two patients: In one patient a staphylococcal infection developed in the breast pocket after a traumatic hematoma that occurred 2 weeks after surgery. Another patient required implant exchange for a smaller one to achieve better symmetry. Nipple sensation was not affected adversely by the surgery. Ultimately, all patients achieved acceptable symmetry and were satisfied with the results.