This is a 45 year old woman from Tucson, Arizona that came to Rao Plastic Surgery interested in a breast reduction. She had been experiencing back, neck, and shoulder pain as a result of her large breasts. She was wearing a G cup bra and her goal was to be a D cup. In addition to her back, neck, and shoulder pain she was experiencing bra strap grooving, as well as rashes in her inframammary fold. She did not have any prior history of breast problems and her yearly mammograms have been normal. She did not have a strong family history for breast cancer. On exam, she did not have any masses in her breasts or in her axilla. During her consultation I felt she was an excellent candidate for a breast reduction. I discussed with her what a breast reduction surgery would involve and explained that I would use a medial pedicle to maintain the blood supply to her nipple-areola complex. I also discussed using a wise pattern or anchor incision to perform her reduction. I explained that this technique would allow us to remove the largest amount of skin and breast tissue to get her to the full D cup that she was hoping to be. Her surgery was performed at an outpatient facility in Tucson, Arizona. Her postoperative course was uneventful. She is now over a year out from her surgery and loves that she no longer experiences the neck, back and shoulder pain that she had prior to her breast reduction.