47-year-old female who is here today for consultation to discuss options for breast reduction. She is accompanied by her husband, and she was referred to me by her friend who is a former breast reconstruction patient of mine. She states she has dealt with issues with her large breasts all her life. She has worked on losing weight, and feels like her weight is very stable, but even with weight loss, she does not have any changes in her breasts. She feels like the size of her breasts impairs her ability to exercise and do the things she enjoys doing. She feels like she has poor posture because of the weight of her breasts, and she complains of neck, back, shoulder, and breast pain. She reports undergoing chiropractic care for her back and neck issues; she had to stop these visits due to the financial burden, but noted that it had not helped much to begin with. Her primary care physician has prescribed her 800mg Ibuprofen for her chronic neck and back pain, as well as for frequent headaches that he associated with her excess breast tissue. She also notes intermittent skin breakdown, especially during the summer months, where the skin under her breasts becomes very “raw.” Her primary care physician has also recommended over-the-counter remedies such as baby powder or neosporin, which helps at times. She currently wears a G or an H bra, and feels like they need to be much smaller. She would like them to be attractive and proportional to her body. She also states the left breast is larger than the right, and wants to know if they can be made to be more symmetrical in size. She has tried wearing two bras at a time, and she has permanent shoulder grooving from her bra straps. She always wears a bra at night because it is painful when she lays on her side or rolls onto her breast. Height is 5’4″. Weight is 195 pounds. She had a bilateral breast reduction with a total of 421 gm removed from the left breast, and 375 gm removed from the right; with nipple position corrected as well (see images). The procedure was performed on an outpatient basis under general anesthesia. Results shown at 3 months.