This patient is a female in her late 40's who presented to my office with complaints of back, neck and shoulder pain due to large pendulous breasts. The patient was also noted to have severe asymmetry as well as significant ptosis. I felt a bilateral breast reduction would give the patient significant improvement in her back, neck and shoulder symptoms. Given the patient's relatively weak tissues and lack of fullness in the upper chest, I felt that fat grafting in the upper and medial poles would help create a more aesthetic shape. The patient wished to have liposuction to the flanks and I felt this would be a good donor site. The patient was also noted to have an indentation of the right flank due to prior injury and I felt this could be fat grafted to improve the contouring.
I performed a breast reduction removing 436 grams from the right breast and 282 grams from the left due to her asymmetry. Liposuction of the flanks was performed and the fat was processed and reinjected into the upper breasts and the flank irregularity. Approximately 30 cc of fat was injected into the right flank irregularity and 90 cc into each upper and medial breast area. The patient was extremely happy with her new appearance and the improvement in her physical symptoms.