This is a 58 year old woman who had undergone bilateral breast augmentation with lift many years previously.  Over time and with progressive weight gain her breasts had enlarged and become very droopy and heavy.  She wished to have the breast implants removed and the breasts lifted.  She underwent bilateral breast implant removal, total capsulectomies, and full secondary breast lift (mastopexy).  She is shown before surgery and almost four months post-op.