This is a 49 year old woman who had breast augmentation with 300cc saline implants several years ago.  She had a tuberous breast deformity which was still noticeable, and her breasts had become droopy in the years since her breast augmentation.  Also. she felt that her original breast implants were a bit too large for her, and she desired smaller, more lifted, and more “natural” looking breasts.  She underwent bilateral  breast implant removal and replacement with smaller 250cc moderate profile silicone gel breast implants.  She also underwent bilateral breast lift (mastopexy). She is shown before surgery with high, malpositioned implants and drooping breasts and about six months after surgery.