Managing breast asymmetry during the course of breast reconstruction is a common problem for the reconstructive surgeon. Designing the surgical incisions which will achieve a correction can be daunting – even for those gifted in visualizing spatial relationships. In an effort to mitigate this surgical challenge, to standardize our outcomes, and to achieve consistently reproducible results, we utilize a 3-D tape moulage technique to plan our surgical correction. A template simulating the breast shape is fabricated from adhesive tape placed over the breast which is to be matched. The moulage is then removed and incised in the manner of a Wise pattern. The moulage is then turned inside out and replaced over the breast to be modified. The outline of this moulage acts as a reference to guide placement of incisions, nipple location, and areas of tissue to be excised. The tape moulage is a simple, reliable, intuitive, expedient, and inexpensive technique that provides a predictable result. We have found the 3-D tape moulage technique to be a useful adjunct to our reconstructive armamentarium. It has significantly enhanced our ability to achieve satisfactory breast symmetry.