20 year old female with large breasts causing shoulder pain, back pain, and neck pain. She also has significant breast asymmetry with the right breast being larger and located lower on the chest. This patient had difficulty finding bra the fit properly, and she also expressed desire for cosmetic improvement. She underwent breast reduction using the “anchor” incision pattern. The breasts have been made smaller and lifted. The areola diameter is smaller, and her symmetry is significantly improved. She is shown 4 months after breast reduction surgery and has complete relief of neck and shoulder pain as well as cosmetic improvement.