This set of breast augmentation before and after photos features a 39 year old female, 5' 4", 135 lbs who 11 years ago underwent subglandular augmentation mammaplasty with smooth saline implants. Since that time she has had one child and did breastfeed without any difficulty. Unfortunately she presented with many of the long term consequences of subglandular augmentation. There was marked rippling of the prothesis which was visible and easily felt. The breast themselves had taken on a melon like appearance from the glandular ptosis that develops overtime from the weight of the subglandular prothersis. In order to correct this deformity the implants were switched from a subglandular to a submuscular position with 375 cc moderate smooth silicone prothesis. A vertical mastopexy was also carried out. This brought the nipple areola to the appropriate height on the newly created breast mound and allowed excision of excess skin and tissue. She had a completly uneventful post-operative course. Six months later she is completly healed. The breast are now elevated and firm with a very natural appearance. The scars have settled in nicely and will continue to do so. She has gone from a droopy melon like appearance to one that is much more asthetically pleasing.