This is a 28 year old woman with hypertrophy and grade 3 ptosis in her breasts who was seeking a consultation for a breast reduction and possible mastopexy at Rao Plastic Surgery. She was wearing DD cup bras and was looking to be around a C cup. She was experiencing back, neck and shoulder pain caused by her large, heavy breasts. Our physical examination showed bra strap grooving, inframmatory fold rashes, as well as grade 3 ptosis, or sagging, of her breasts. During her consultation, I believed she would be a great candidate for breast reduction surgery as well as a mastopexy, or breast lift, in order to help her achieve the comfort and appearance that she was searching for. Soon after, I performed the surgery at an outpatient surgery center in Tucson, AZ. The size of her breasts were slightly different. Based on the size and symmetrical difference, I used an anchor incision technique, and removed 250 grams of breast tissue from the right side, which preoperatively was significantly larger than the left breast. I then removed 327 grams of breast tissue from the left side, and performed the breast lift to follow, which created the best symmetry. The surgery went well, and she had a smooth post-operative course. It has now been a few years years since her surgery, and is no longer experiencing the pain and discomfort that she had pre-operatively. She is a happy, confident, and satisfied woman post-surgery!