65 year old patient from Vancouver, WA. She was originally a small A cup and after 4 breast augmentations and a mastopexy (breast lift) over the years with other doctors she ended up DD cup. The last augmentation surgery in 2015 textured implants were placed and she now had concerns about ALCL that is linked to textured implants. She was also concerned about the size, she feels they were too large. She did have some capsular contracture but without distortion of the breast shape and some sagging of the breasts. Due to the implants being textured the patient decided to have her breast implants removed with total capsulectomy to remove as much of the capsule as possible even though this would leave her mid B range. The patient also decided on a breast lift to raise her nipple area. She is relieved to have the implants removed.