This 39-year-old woman had a previous breast augmentation by another surgeon. She had 390 cc textured round saline implants placed in front of her muscle, which left her with a poor shape, rippling of the implants in particular at the upper pole, and breast ptosis. I performed a 2 stage revision. In the first stage, we removed her saline implants and their capsule, created a new pocket behind her muscle, and reinforced this pocket with an ADM (acellular dermal matrix) to act as an internal bra to hold and support the implant. In the second stage, I performed a full breast lift or mastopexy. Her post-op photos taken 6 weeks after her 2nd and final procedure show a dramatic result — excellent implant position, good fullness in the upper pole, no rippling, and very nice nipple position, all with incisions that will lighten and fade over time.