This 67 year old patient underwent silicone breast augmentation 30 years prior and presented with bilateral ruptured silicone implants and grade 4 capsular contracture on the right. Her original surgery was performed via an inframammary incision (in the crease) on top of the muscle (subglandular). Complete removal of the breast implant capsule (total capsulectomy), removal of both ruptured implants, and removal of extracapsular gel was required. The patient desired reaugmentation in order to maintain shape and volume. Allergan 371cc and 397cc style 15 moderate profile silicone implants were placed to compensate for asymmetry. Her new implants were placed beneath the muscle (pocket reassignment) to give a more natural look and to reduce the risk of recurrent capsular contracture. Her previous inframammary incision was used. Her shape is much improved, and she has a natural contour. Her breasts are soft and not tender. She shown 5 months after surgery and is very pleased with her results.