This 36-year-old female patient underwent a breast implant exchange, mastopexy, and posterior trunk liposuction. The procedure involved the removal of her previous Mentor smooth round silicone implants—325cc on the right and 350cc on the left. A total of 600 mL of liposuction aspirate was removed. New 230cc Sientra HSC smooth round silicone implants were placed bilaterally, providing a more natural contour and reduced breast size while maintaining upper pole fullness. The patient’s primary goals were to reduce implant volume and improve breast shape by addressing ptosis and lipodystrophy.