60 Year Old patient with multiple medical problems including hypertension, heart disease and severe cervical and neck pain and disc herniation. Patient with medical problems also can undergo a breast reduction. We like to engage the primary care doctor to assist our patient in stabilizing any ongoing medical problems prior to surgery. Preoperative primary care support and surgical preparation reduces the patients risk for post operative complications. This patient underwent a bilateral breast reduction in the hospital and had an uneventful postoperative course. Her scars are somewhat widened, which is not ideal but can occur in patients. She is thrilled with her result and for the first time in decades has no neck and back pain. Reduction mass was 1400 grams left breast and 1100 right breast.