This patient is a 45 year old woman who had undergone previous breast augmentation with lift procedure, who presented for a revision procedure to address firmness issues on the right side. She also reported that her breast size had gotten much larger over time and that she would like to have a smaller breast size to allow for more comfortable routine exercise and tennis. She requested a procedure to have smaller breast size, higher breast position, improved shape. Following discussion of treatment options, she elected to pursue a procedure to have her breast implants removed and have a revision breast lift to attempt to provide optimal shape with the minimal amount of breast tissue present. She has been very pleased with her outcome to date.