This active woman in her early 40s initially had saline breast implants placed almost 20 years ago. She had 510 cc saline implants, but wanted to go to a somewhat smaller size, convert the implants to the softer silicone gel implants, and have a breast lift to improve the shape of the breasts. Dr. Nachbar exchanged these implants with somewhat smaller, 400 cc silicone gel breast implants under the pectoralis muscle, and performed a breast lift to tighten and improve the shape of the breasts. She is shown 10 months later.