This 54 year-old patient had Silicone Breast Augmentation 30 years ago. Her breasts have gradually sagged well below the implants and she has noticed progressive hardening of both implants for 5 years. She had small leaks of both implants with capsule contractures (hardening of scar tissue around the implants) and significant sagging of both breasts. She underwent removal of both ruptured impants and scar capsules, replacement with 400cc silicone gel implants, and a vertical breast lift. She is shown 6 months after surgery with a 38D cup size.