BACKGROUND: Breasts are an integrai part of feminine beauty and breast symmelry is a key lo beautlful formo Severe breasl asymmelry can be psychologically dislurbing, especially for teenagers. Correction of breast asymmetry may present a challenge for plastlc surgeons. PATlENTS AND METHODS: 72 cases of breast asymmetry complalning of varying degree and etlology of breasl asymmelry, treated between December 2009 and December 2012. Their age ranged from 18 lo 65 years, with Ihe mean age was 34 years. Every palient conducted doctor interview for good psychological analysls. Preoperallve clinical assessment of the specific anatomical deformity, a good surgical pian, subsequent surgical treatment modalities, esthetic outcome, and patient's satisfactlon were evaluated. Surgical modalilies used in Ihls series included augmentation mammaplasty, reduction mammaplasty, mastopexy, T.R.A.M flap, multiple z plasties, Thoracodorsal flap, and nipple and areola reconstructlon. Ali patlents were done under generai anesthesia. RESULT: 25% palients (18fl2) had breast asymmetry alter mastectomy, 20.8 % patients (15/72) had virginal hypertrophy asymmetry, 16.7 % patients (12/72 ) presented by breast asymmetry alter burn, 12.5% patients (9/72) presented by bilateral developmental hypoplasla with small-volume asymmetry, 12.5% patients (9fl2) had Poland's syndrome, 8.3% patients (6/72) liad a iatrogenic breast asymmetry following breast surgery and 4.2% patients (3/72) presented by breast asymmetry following hemi- Irunk atrophy. 9 of 72 patients were found to have a minor complication, whereas 2 of 72 were found to have a major complication. CONCWSION: The common cause of breast asymmelry Ihat ultlmalely undergo surgery in Upper Egypt was post maslectomy and the least type was breasl asymmetry following heml- Irunk atrophy. Patients' satisfaction were 83.3%, while 73% was the physician' satisfaction. The keys to successful treatment are to deline Ihe nalure of the asymmelry, respect the aesthetic goals of·the patient, and perform a well thought out surglcal pian.