This beautiful young lady had had a previous breast reduction which she felt did not decrease the size of her breasts at all, but rather left her nipples in a location that pointed down and she felt were actually descending underneath her breasts. This was likely due to an attempt to minimize scarring. While it is always our goal to minimize scarring, particularly in patient who may have more of a propensity to form bad scars (such as those patient who have more pigment in their skin), but it is never a reason to trade results of the contour. By minimizing tension on the closure of the incisions and paying close attention to the scar care in the healing phase, we can minimize scarring and still offer the best shape and effective reduction even to our most at risk patients. This patient now enjoys a reduced breast with a lovely shape that is less painful and you can barely see her scars just one year later.