Patient is a 19-year-old woman who had large pendulous, breasts and signs and symptoms of macromastia, including neck and back pain, bra strap grooving, rashes, etc. In addition she had breast asymmetry. She underwent a vertical pedicle breast reduction and lift to alleviate her symptoms and improve her breast aesthetics. 149 g is removed from the left breast and three or 5 g from the right. She is six months post in the after images.