Controversy over the theoretical complications from silicone gel breast prostheses has led many patients to pursue explantation or removal of the implants. Consequently, the breast is often misshapened. An internal mastopexy can be performed in conjunction with explantation, requiring little additional operative time and no additional scars. Although limited by tissue availability, the procedure can minimize ptosis and improve projection. On the basis of our experience with 27 patients, we feel that the internal mastopexy following explantation is a worthwhile consideration for selected patients.