This is a 48 year old white female. She is 5’7” and 138lbs. In 2008 she underwent a bilateral subglandular augmentation with implants in the 200cc range. She unfortunately developed a capsule on the left side and underwent a left open capsulotomy in 2010 by her surgeon. At about the same time she also developed a capsule on the right which was not treated. Upon examination in my office she had bilateral Bakers Class III capsules. The breasts were quite firm, tender and she had glandular ptosis. Her bra size was a 34C. We discussed options which would include bilateral complete capsulectomies, removal of the implants, which were silicone and placing new implants in a submuscular position. Her desire was to be slightly larger. Having weighed her options she decided to proceed and underwent bilateral capsulectomies with a change of implants to the subpectoral position. She was re-augmented with 300cc moderate plus smooth silicone prosthesis and because of the slight excess tissue on the left; a left periareolar mastopexy was also performed. Her postoperative course was uneventful and three months postoperatively she has shown no signs of re-encapsulation. The breasts are soft and nicely positioned without the abnormal high sitting tight encapsulated breasts that one sees in a subglandular augmentation. The incisions are healing nicely and she is ecstatic with her new natural appearing breasts.