Recently, our department successfully performed a rare case of severe breast ptosis combined with breast sagging plastic surgery. Severe breast ptosis combined with breast sagging has caused many women unspeakable inferiority, embarrassment and heavy burden of life due to its huge appearance and abnormal body shape. The difficulty of the surgery lies in the resolution of the nipple areola blood flow and shaping, our department prepared the patient’s body shape and breast characteristics, designed a detailed surgical plan before surgery, and finally adopted a modified double-ring short-scar inferior tibial flap method with external oblique incision, combined with nipple areola reduction plastic surgery, breast lift suspension and other advanced technologies to create a pair of perfect and healthy breasts for the patient. The patient was able to create a pair of perfect and healthy breasts, which filled the gap of giant breast surgery in our province and eliminated the worries that had been troubling the patient’s physical and mental health for a long time. At present, the patient has been cured and discharged from the hospital, and is very satisfied with the results of the surgery.