This lady has previously had a breast augmentation elsewhere over 10 years ago and was diagnosed with an implant rupture on the left side. This has caused distortion of the breast. Surgery in this instance requires enbloc removal of the capsule and the implant. This lady wished to be increased in volume afterwards and also to have the breasts moved more centrally. She did not wish to have a mastopexy. It is important for patients to realize that over time that the breast tissue will drop and a mastopexy will be required and also that if asymmetry exists preop that there will be asymmetry afterwards.