Large breasts are embarrassing for women and can make their lives difficult. Breast enlargement is mainly related to genetics, poor breast maintenance, obesity and prolonged breastfeeding. In adolescent girls, large breasts are obese because they grow too fast during the first few months of puberty. At this time the patient is only about 11-15 years old, a sensitive period of growth and development, and gigantism is very harmful to the physical and mental development of girls and the building of self-confidence. It has been explained that it is caused by the hypersensitivity of the breast glands to estrogen in such patients and that breast reduction mammaplasty is the only practical solution to the problem. Many women’s breasts do not return to their original size after breastfeeding, and as time passes, they become both larger and heavier due to increased fat in the breasts and decreased skin elasticity, which causes significant sagging. At this point, breast reduction and suspension surgery is the best option for them. In our group of cases who had breast reduction surgery, other aspects of their lives improved as well. Neck pain or back pain has been reduced, body shape has improved, and in some cases, sex life has improved. With the improvement of living standards and lifestyles in the last decade or so, the number of patients suffering from breast enlargement has increased significantly during the same period, especially during the developmental stage of adolescence, where the incidence of “breast enlargement” is on the rise. The number of patients coming to our clinic now is about four times what it was three years ago. In the 17 years since the beginning of 1993, we have performed breast reduction surgery using the new medial dermal gland flap method on more than 200 cases of mastopexy, with a satisfaction rate of 85%, overcoming the shortcomings of previous surgical methods. Clinical practice proves that this surgical method can fully achieve: ① excise the glandular tissue as needed; ② obtain a symmetrical breast shape with cosmetic effect, with the nipple located at the apex of the breast; ③ the scar is located in the hidden part of the breast and is relatively short; ④ maintain normal sensation and lactation function; ⑤ easy operation, less bleeding and short time; ⑥ the surgical effect is long lasting. Therefore, it is especially suitable for patients with severe cystic fibroplasia macromastia of the breast (see Figures 1 and 2). Figure 1 (preoperative) Figure 1 (postoperative) Figure 2 (preoperative) Figure 2 (postoperative) Recently we also did a case of severe double gigantomastoid ptosis in an elderly patient, especially in recent years the ptosis became more and more obvious, up to 6 cm below the navel, with neck, back and shoulder pain, making life very inconvenient. Especially in summer, the dermatitis at the breast folds was serious. After the reduction surgery, the patient seemed to be liberated and very happy, and the family was satisfied. See Figure 3. Figure 3 Pre-operative frontal Figure 3 Patient post-operative frontal The same method is also applicable to patients with asymmetric breasts, especially unilateral hypertrophy can be done unilateral reduction; asymmetric bilateral breast hypertrophy, can be done bilateral breast unequal reduction, so that these patients can achieve balanced symmetry of both breasts, and upright, enhance the patient’s self-confidence (see Figure 4). Figure 4 (pre-operative) Figure 4 (post-operative) The new breast reduction also brings new life to patients with breast cancer with gigantomastia. We also perform this program in patients with breast cancer with gigantomastia, which is a new concept in breast oncoplastic surgery that is currently popular internationally, with ideal tumor management and the most cosmetic results possible for the breast, and in appropriate cases, preoperative chemotherapy to shrink the mass before surgery (see Figure 5). Performing bilateral reduction plastic surgery at the same time as breast-conserving surgery can kill two birds with one stone, greatly reduce the patient’s psychological stress and can improve the quality of life. Figure 5 (preoperative) Figure 5 (postoperative) In our group of cases with 1.5 to 4 years of follow-up, no local recurrence occurred, and the patient satisfaction rate was 83%. Bilateral reduction mammaplasty is a feasible and safe approach for patients with breast cancer with macromastia who wish to undergo breast-conserving surgery and would be an innovation in breast oncology surgery.