This is a 51 year-old who had a saline subglandular breast augmentation in her 30’s who felt her breasts were now too big, pulled on her neck, and she no longer wanted implants(Photo 9A). She was a C cup and would tolerate as small as an A cup. One advantage to having saline implants is they can be emptied with a needle with local anesthesia and patients can see how they would look without implants and without fat grafting or a breast lift(skin reduction) procedure(Photo 9B). She was happy with the size of the breasts without an implant and she then underwent removal of her implant, removal of skin at her breast folds, and 25cc of fat were grafted in the subcutaneous space of each breast. This is her 2 month post-op result(Photo 9C). The fat grafting allowed the upper part of the breast to look soft and natural, instead of empty and hollow from having an implant in place for so many years.