33yo female with saline subglandular implants that displayed severe wrinkling/rippling

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This is a 33yo female with saline subglandular implants that displayed severe wrinkling/rippling.  She wanted to reduce the wrinkling/rippling and replace her old implants but avoid a lift.  Therefore, her saline implants were ruptured (seen in photo) in the office to allow for skin contraction for a few weeks.  She then proceeded to the OR where smooth round silicone gel implants (450cc) were placed in the submuscular location.  Her skin had contracted enough that a lift was avoided.  Photos are 4 months after her surgery.