50 year female with history of a bilateral breast Augmentation 1 year ago, presented to office with asymmetrical, tender, breasts and double bubble animation. Patient wanted to have symmetrical and natural breasts. Dr. Samir Shah performed a removal of implants with replacement of silicone breast implants, bilateral mastopexy, mesh support, and fat transfer to bilateral breasts to improve breast shape. Mentor silicone breasts implants were used with 300 cc volume. The final result was achieved and provided patient with symmetrical, round and full breasts.