This patient is a 55 year-old woman with a 20 year history of intense and progressive neck and shoulder pain because of severe breast enlargement, which was only partially relieved by pain medicines and chiropractic treatments. When first evaluated by Dr. Fata, her breasts were measured as a 34H cup size. Dr. Fata recommended and performed a breast reduction using the "Vertical" technique. Within 2 months her symptoms of pain had resolved and she was reduced to a D cup. She is shown before and one year after breast reduction surgery.