Breast implant removal

This 50 something lady had breast augmentation with silicone breast implants 20+ years ago when she was very slender and (her words) "as flat as an ironing board." Fast forward into post menopause. Her implants looked ruptured on mammogram (one was) and she wants them out. She's afraid of how she will look after implant removal but after surgery, she is pleasantly surprised. She had a lot more "real" breast than she ever dreamed of. I see this frequently in patients in this age group. The middle age weight gain often goes to the chest and patients aren't as "flat" as they remember themselves to be. This patient may end up having some fat transfer to improve her shape, but she's not sure.