This is a 24 year old female presented to the office with complaints of large breasts breast and breast asymmetry that causes her back and shoulder pain – worsening throughout the day. She had tried other conservative measures to reduce her symptoms without benefit. Her pre-op exam demonstrated very large, sagging breasts with significant asymmetry. She underwent a bilateral, inferior pedicle, “T” pattern, asymmetric breast reduction. At 4 months, she is very happy with the smaller, lifted appearance of her breasts and is back to normal activities.