Correction of symmastia can be very challenging. It is often so severe that it created additional malposition of the nipples along with implant malposition. The solution here required total anterior and partial posterior capsulectomy (removal of scar tissue) in order to set the foundation for a new implant footprint. Then strattice graft is used to help create the new implant space. A more appropriate implant is chosen, and the overlying breast tissues are rotated over the top to reposition and recentralize the breast. An outstanding outcome.