This is a 42 year old woman who had breast augmentation with saline implants almost 20 years previously. Over those 20 years she had developed progressive drooping of her breasts and lateral displacement of her saline implants. In preparation for her surgery, the saline implants were deflated in the office. In order to achieve improvement in the position of her new silicone gel implants and correct the drooping, she underwent removal of the deflated saline implants, breast pocket modification to center the new implants, and mastopexies (breast lift). She is shown before surgery (after implant deflation) and about four weeks post op. Her new silicone gel implants are 485cc for the right and 450cc for the left. Both new implants are SRX (highest) profile.