This patient had large saline implants placed above the muscle years ago by another surgeon which eventually lead to sagging and malposition.  She underwent a 2-stage procedure, which involved removing the old implants and capsule with a breast lift, followed by submuscular breast augmentation with silicone gel implants 4 months after her first surgery.  This is an example of staging a procedure in order to deliver the best cosmetic result in the safest manner possible.