This is a 40 year old patient that had a previous history of breast augmentation 14 years ago elsewhere. She has some changes to her breasts with pregnancy and now desired to be a bit full. She underwent a removal of old subglandular (on top of the muscle) implants with lower pole capsulectomy and superomedial capsulotomy (to expand the pocket and remove some of the scar tissue envelope to allow for a larger breast implant) and replacement of new 440 HP (high profile) Sientra cohesive silicone gel breast implants. 6 week after results are shown.