This patient in her 50s had her initial breast augmentation 5 years prior with placement of submuscular silicone implants (286 cc). Over time, she developed significant mobility of the implants with lateral displacement when lying down and loss of upper pole and medial breast volume. She underwent a revision procedure with implant removal, superior/medial capsulotomy with inferior/lateral capsulectomy and capsulorrhaphy, and placement of new cohesive gel silicone implants (445 cc). In addition, she also had placement of surgical mesh to form an internal bra to support the implant and add strength to the inferior soft tissue envelope. She chose not to undergo a breast lift (mastopexy) to avoid additional scarring.