Description: This patient has severe sagging and elongation of the breasts. The skin envelop has been expanded with an excess of skin. The "extra" quantity of skin in this patient as well as the severe sagging of the breast, was effectively managed by using an "anchor" technique to excise the horizontal excess of skin along the inframammary fold. The resulting scar is oriented into an "inverted T". The scar is longer than with a vertical breast reduction, however, the closure is smoother and generally hidden within the crease of the inframammary fold. A superior pedicle for the nipple vascularity was used to retain and recruit tissue preferentially to the flattened upper breast pole found in this patient. The shape of the resulting breast is fuller than with traditional inferior pedicle techniques. The likelihood of breast feeding following superior pedicle breast reduction surgery is diminished. Nipple sensation often is reduced following superior pedicle breast reduction. Superior pedicle breast reduction is typically performed as an outpatient procedure. This patient demonstrated a preexisting breast asymmetry that was improved by the removal of a larger volume of breast from the right side. 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 a superior pedicle of tissue attachment | Quantity of breast excised was of moderate weight (right 829g, left 669g). Photographic documentation was obtained at 5 weeks and 5 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.