38 year old female who desired more information about breast reduction. She did not breast feed either of her children, and she does not plan to have any more children in the future. She states in the last year or more, she has gained about 40-50 pounds. Height is 5’6″. Weight is 240 pounds. Her bra size went from a 38GG to a DDD, and her breasts “have started to extend under my arms.” She also states her nipples are very low and much larger. She has had a significant increase in back, shoulder, neck, and breast pain, and that her bras leave large painful indentations on her shoulders. She had a bilateral breast reduction performed, with a total of 1000 gm removed from the left breast, and 1000 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.