43 year old female. She had a breast augmentation ten years previously: she was not happy with her results (her implants are too high), but the doctor did not address her issues. She presented to us to address her issues for her, which included the positioning of the implants and the implant size. She desired bigger implants. According to her, she had saline, smooth round implants placed initially: the left breast implant is 240cc’s and the right breast is 250cc’s. Height is 5’3″. Weight is 127 pounds. The procedure was performed in-office in our fully accredited (AAAASF) facility under light sedation and local anesthesia: we extensively revised the breast pockets to get the new implants behind the nipple (correcting their malposition) and also removing the old implants and replacing with 450 cc silicone gel implants. Results are shown at 3 months.