Patient presented with ruptured left breast saline implant. She had breast augmentation 25 years ago, now with deflation and rupture of left breast implant. Implant was inserted via peri-areolar incision. Patient was seen and examined and I recommended removal of bilateral breast implants, capsulorrhaphy, implant pocket revision and insertion of new implants. Patient wanted to go with silicone implants. Patient underwent removal of bilateral breast implants (left side ruptured, right side intact) through an inframammary fold incision and her implant pockets were noted to be enlarged and lateralized over time. As such, implant pocket was revised and capsulorrhaphy was was performed to lift and medialized the implant pocket. Natrelle Inspira (Allergan) 330 cc silicone implants were then inserted (previous implants were 320 cc implants). Note the asymmetry of nipple-areolar complex that existed before the surgery. This does not change with surgery. A corrective surgery for the nipple areolar complex can be performed to even out the nipples but patient did not want to do this at this time.