This 41-year old mother of two, who is 5’9″ tall and weighs 135 lbs. had 360 cc silicone gel implants placed over the muscle 23 years ago. She had bilateral capsular contractures with a rupture of the Right breast implant. The implants were replaced with 550 cc silicone gel implants. A periareolar incision was used and placement was on top of the muscle. She went from a bra size of 36C to 36D.