Breast revision mastopexy and removal of saline implants with replacement with silicone smooth round high profile / abdominoplasty and plication of massive diastasis rectii. 34 yo 5′ 4″ had previous saline implants with Grade II capsular contracture with glandular and skin sagging. She underwent bilateral breast periareolar lift, capsulotomy and removal of saline implants and replacement with silicone gel high profile 500 cc subpectoral implants and same time abdominoplasty with layered tightening of loosened abdominal muscles.