This 49 year old white female had breast implants inserted approximately 20 years earlier. The patient presents with severe deformity of the nipple areolar complexes. She feels that her breasts are “too large” and requests explantation. She underwent bilateral removal of her breast implants, capsulectomy to remove the scar tissue capsule around the mammary pocket and allow the breast tissue to heal together. No new breast implants were inserted. She underwent bilateral mastopexy. Her postoperative result at nine months shows reduction in the diameter of the nipple areolar complexes, a nice overall shape and slightly smaller breasts but still adequate breast volume.