48 year old patient who had previous breast augmentation and revision with placement of Highly Cohesive 445cc Extra High Profile implants with resultant gap at her cleavage site with stretched lower poles of her breast skin given the weight of the Highly Cohesive silicone gel implants. Therefore she underwent a bilateral breast revision with removal and replacement of the Extra High Profile Highly Cohesive silicone gel implants to a Moderate Profile 485cc natural feel silicone implants (not as highly cohesive and heavy) with internal lift of the breast pocket performed via a periareolar incision with a periareolar breast lift.