53 year old woman had breast augmentation in the remote past with 350cc saline implants.  She recently experienced deflation of the left implant and presented with asymmetry of the breasts and drooping of the deflated left breast.  She wanted a correction of the breasts to reduce their size, to make them more symmetrical, and to lift them.  She underwent removal of the old saline implants, secondary augmentation with 270cc silicone gel implants, and bilateral breast lifts (mastopexies).  She is shown before surgery and about 6-8 weeks post-op.  Her bra size changed from D-cup to C-cup.