This patient suffered from the usual upper back & neck pains, bra strap grooving, and rashes due to her large breasts. She underwent reduction by Dr. Geiger using a Wise Pattern skin incision and free nipple technique. This allows removal of the entire lower, heavy breast tissue. The remaining upper breast tissue is reshaped and the nipple is sutured back on the breast as a skin graft. This allows a large volume of excess tissue to be removed while creating a very pleasing, projecting breast shape that will last. This patient had over 5.1 pounds of breast tissue removed (right breast 1162 grams, left breast 1178 grams removed). She looks and feels amazing with her new size and shape.