She returneed 21 years later with deflation of her right implant. Saline implants have a deflation rate of about 1% per year over their life. Her left breast was a bit firm and this can contribute to a higher likely of failure of a saline implant. 

I removed both implants and some of the scar around them. I also drew some fluid from around the implants. I had both checked for lymphoma cells since this has been associated with textured implants. All of this was benign. 

Her new implants are Mentor round, smooth, moderate profile saline implants filled to 300 cc. To try to prevent recurreing tightening of her scar around the implants, I put her on a month long course of two drugs, a low dose antibiotic and a drug used for asthma that has been shown to be useful in keeping implants soft. Her final photo is shown. Her breasts are exquisitely soft and she has all of her normal sensitivity. Her bra size is 36 C.