53 year old trans-woman who had been on estrogen hormone replacement therapy for years and with previous silicone implants in the prepectoral position that had experienced bilateral capsular contracture and rupture. She underwent a revision with bilateral total capsulectomy and removal of the ruptured silicone implants with replacement in the dual plane position with 440cc High Profile new silicone gel breast implants to achieve a natural appearing 36 C cup breasts.