Description: Breast reductions exceeding 1kg are considered to be massive. The large volume of breast reduced required planning on how best to reposition the nipple. The nipple is often the furthest point from the base of the breast from where it derives its vascularity and nourishment. The massively enlarged breast has an elongated distance to the breast base resulting in an elevated risk of circulatory compromise with pedicle breast reduction techniques. In this case of massive breast enlargement, a traditional inferior pedicle technique was planned and carried out to preserve circulation to the nipple. This technique is more likely to preserve the ability to breast feed as well as the sensation of the nipple. Pattern of skin excision was vertical and horizontal giving rise to an "anchor" or "Inverted-T" scar | Vascular circulation to the nipple and areola was preserved by maintaining an inferior pedicle of tissue attachment | Quantity of breast excised was of massive weight (right 1331g, left 1350g). Photographic documentation was obtained at 3 months after surgery. Note that surgical cases of Dr. Chen Lee are presented for illustrative and educational purposes only. These illustrative cases should not be construed as a guarantee nor assurance as to the surgical results attainable by prospective patients.