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This 5'1", 124-lb patient first came to Dr. Piazza at age 37 after two previous breast surgeries: an augmentation in 2010 followed by an implant exchange in 2021. She was concerned about progressive changes in her breast shape, including visible indentation of the left breast and loss of definition between her breasts. Examination revealed significant implant malposition, with both implants sitting too low and too close together, resulting in bottoming out and symmastia, where the breasts meet across the center of the chest. Her revision required more than simply exchanging her implants. Dr. Piazza reconstructed the breast pockets, repositioned the previously released chest muscle back against the chest wall, and created new subglandular pockets to restore separation and improve implant position. GalaFLEX® internal support was added to reinforce the new pockets and provide additional support for the implants. Because she desired a fuller, more projected result, her implants were exchanged for 495cc Natrelle INSPIRA® SoftTouch Extra-Full Profile (SSX) silicone gel implants, creating greater volume and projection while restoring a more defined separation between the breasts. Individual results vary.