This 60 year old patient had very large saline implants that had been placed in front of her muscle years ago. She was interested in smaller implants and a perkier, more youthful appearance. We removed her old, large saline implants and created a new space for smaller silicone implants behind her muscle, utilizing an internal scaffold or “bra” to support her implants, and completed the procedure with a full mastopexy (breast lift). This created an excellent, symmetrical result, smaller more youthful breasts that were more in balance with her frame.