This 37 year old woman from Maineville, Ohio had a breast augmentation in earlier years. Her left breast implant started pushing out the side. She had three prior operations by another plastic surgeon with no improvement. She heard that the best plastic surgeon for this was Dr. Bivik Shah and came to see us. He described to her that an implant exchange, with a capsulorrhapy (tightening of the capsule) and removal of skin would achieve what she wanted. The implants were placed above the muscle as requested by the patient. The after photo was taken 4 months after surgery.