This is a 54 year old patient who had previous textured saline breast implants that developed a spontaneous deflation on the left side after 13 years and a capsular contraction on the right side with superior malposition (the right implant was contracted, hardened and too high). She wanted a more natural look and feel. She underwent removal of old textured, saline implants, a capsulectomy and a replacement of smooth, round silicone gel breast implants with the use of ADM (acellular dermal matrix) in the lower pole to prevent recurrent capsular contraction and control the positon of the implant. 10 week after photos are shown.