This is a 51 year old woman who had undergone bilateral breast augmentation in the distant past with saline implants filled to the high 400’s cc range. She wished to have smaller and more lifted beasts. She underwent secondary breast surgery by removal of the original breast implants and replacement with smaller implants in the high 200’s cc range. Final implant volume adjustments were made to achieve symmetry. She also underwent bilateral breast lift (mastopexy). She is shown before surgery and seven months post-op.