This 90 pounds, 23 year old female, had undergone breast augmentation by a Cosmetic Surgeon (non-plastic surgeon) 2 years earlier. The patient had 275 cc saline implants placed over her chest muscles. After 1 year, the patient complained to her surgeon about her breast shape and sagging. The surgeon incorrectly filled her implants further to 450 cc each. This resulted in further stretching of her skin and breast tissue. When presenting to Dr. Siamak Agha a year later, the patient's implants were thinly covered with breast tissue and stretched out skin. Also, the implants had caused significant sagging of her breasts and stretching of her nipple areola complex. The patient was so dissatisfied with her experience that she just wanted smaller breasts. Dr. Agha performed a breast augmentation revision on her. This included removal of her implants, placement of 275 cc Silicone implants in a submuscular plane, and peri-areolar mastopexy . Patients post-operative pictures are shown at 9 months.