This 14 year-old woman developed very large, heavy breasts since puberty, but had been stable at this size for the year prior to her consultation. She is not only symptomatic from her breasts, but is teased by her classmates, and changes for gym class in the toilet stall for privacy. With parental support and approval, she came to Minneapolis Plastic Surgery for breast reduction surgery. Note the skin markings on her pre-op photographs showing the Wise pattern and the degree of anticipated nipple elevation. Her after photos at 6 weeks show scars that will continue to fade over 6-12 months. She retained nipple sensation and ability to breast-feed.