A 44-year-old woman with a BMI of 43.2 kg/m² post-Goldilocks Mastectomy on her right breast and left breast reduction 3 years ago performed elsewhere.  She reportedly had gigantomastia (a rare but disabling condition characterized by excessive breast growth) before her previous surgery, although these photographs are not available to us.  She requests an increase in breast size without the use of implants.  Given her significant excess upper abdominal subcutaneous tissue, she is an ideal candidate for a Reverse Abdominoplasty.  She is shown 3 months after her Reverse Abdominoplasty with improved upper abdominal contour and a significant increase in breast size. She has some fullness centrally which could be further debulked to improve her outcome.