This patient presented with a history of transaxillary breast augmentation with 325 cc silicone implants six years prior.  She developed  bilateral capsular contractures which were hard and painful.  She also had worsening asymmetry.  Because the patient was thin a decision was made to remove her capsules, place dermal matrix and replace her implants.  She now has soft, nonpainful breasts with improved symmetry.  Incisions under breasts.