* This 63 year old woman had a breast lift in her 40’s, and saline filled breast implants were added at a later date. She presented to us feeling that her breasts were too large and saggy. She was requesting a breast lift and possibly smaller breast implants. After examining her the proposed operative strategy became simpler yet. In reality she did not need breast implants to achieve her goal. She had plenty of breast tissue to re-shape and needed a breast lift and small breast reduction. Using the SPAIR technique approximately 75 gms of breast tissue was removed from each breast along with both breast implants. Her remaining breast tissue was reshaped & lifted and her areolas were reduced. She was very pleased with the reduction in the weight of her breasts, breast lift, and aesthetic look of her breasts following her revisionary breast surgery.