This 44 year old patient underwent previous saline breast augmentation in the past elsewhere. She presented with significant asymmetry and displacement of her implants. She has a right grade 3 capsular contracture and drooping of the breast. The right areola is also significant larger. Revision was performed with implant exchange for a slightly larger silicone implant and pocket revision. A total capsulotomy was performed on the right, and a upper and medial capsulotomy on the left. A right periareolar mastopexy was performed on the right to lift and tighten the breast as well as to reduce the areola size. She also underwent liposuction of the abdomen and flanks with fat transfer to the upper and inner portions of the breasts to improve contour. She now has a much more aesthetic pleasing. She is now shown 6 months after surgery and is very pleased with her new result.