This 62 year-old patient presented to Dr. Siamak Agha at Plastic SurgeryBody Contouring Center in Newport Beach with severe capsular contracture and breast pain. The patient had silicone breast augmentation in 1990s. She had capsular contracture for several years but had recently developed breast pain as well. The patient wished to have her contracted implant capsule removed and her implants replaced. On examination, she was found to have hard implants and breast deformity, especially on the right side. Together with breast pain, this classifies the patient's capsular contracture as grade 4 or the most severe. Dr. Agha performed a full capsulectomy on her breasts that included removal of her 290 cc implants from a subglandular pocket and complete excision of the contracted capsule to alleviate her breast pain. Next, the subglandular pocket was closed off and a new pocket was created under the pectoralis muscle. New Natrelle silicone implants of 421 cc were then placed within the developed pockets. These operations were all performed through her existing mammary crease incision. The patient recovered well from these procedures. Post-operative pictures are shown 6 months after her capsulectomy and implant replacement.