Augmentation mastoplasty is a useful procedure to improve body contouring, but when the operation is not well planned, several patients look to remove the prosthesis. The operation must be well evaluated and requires good understanding between patient and surgeon, since it is a reparation of a previous aesthetic procedure. Patients complain about the unaesthetic appearance due to ptosis of the breasts caused by the excessive weight of the prosthesis. The main reason to remove the prosthesis is due to an imbalance between its size and the internal volume of the breasts. When the continent is too wide, or the prosthesis is not big enough to achieve good balance, the patient feels uncomfortable with two bolls on the chest. The operation is to remove the prosthesis, followed by mastopexy to remodel the new beasts. I created an adipose-glandular flap with a superior pedicle to be rotated up and backward, which is sutured on the posterior aspect of the Pitanguy’s “third pedicle.” So far, the second operation must be well evaluated about the remaining mammary gland with accurate clinical examination and also through mammography or magnetic resonance.