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Reconstruction following lumpectomy can be challenging and even more so in the setting of radiation therapy. Radiation and implant reconstructions can often cause capsular contracture. When one mammary prosthesis has capsular contracture and the other does not, obtaining symmetry can be quite challenging. In patients who have repeated capsular contracture, it is often best to remove the mammary prosthesis and obtain the best symmetry possible without implants. This can be done with implant removal and mastopexy.