Patient is a lovely, 70 year-old Caucasian female with history of previous silicone, subglandular breast augmentation performed back in 1977. She noticed hardening of her breasts over 20 years ago and she developed bilateral, severe, Grade IV capsular contractures and documented ruptures on imaging studies including MRI. She never did anything about her breasts as they “didn’t bother her much at the time”, however she complained they were too large, misshapen and causing discomfort. Her mammogram revealed no evidence of malignancy. She complained that her breasts were much too large and heavy, and she wore about a “FF”-cup size and desired to become a much smaller and more comfortable C-cup if possible. She also had severe deformity and asymmetry due to the contractures as well as her left side hanging lower than her right. She underwent removal of her old, ruptured gel implants, total capsulectomies, placement of a small, textured, 285 cc MP Sientra, Textured, Round silicone gel implant in the same, subglandular plane, right vertical and left anchor mastopexies to provide a soft and smaller C-cup size.