A 38 year old lady came to our office requesting a breast implant exchange to go from a B cup and into a full D cup. She also requested removal of her saline breast implant, which felt unnatural and caused her to have rippling many years after her initial breast surgery. In addition, she wanted me to improve her cleavage and place the breast implants closer together. During surgery, a capsule operation was performed that closed the outside and lower portions of the capsule and opened the capsule in the area of the cleavage. The saline breast implants were replaced with 550 cc high profile silicone breast implants. She is now a full D cup.