*This 57 year old woman presented to our office with concerning biopsy results in each of her breasts. She had always had large breasts and had often considered having a breast reduction. Her breast tumors were able to be treated by lumpectomy only. Working together, her general surgeon and reconstructive surgeon developed a surgical plan that would remove the areas of concern and achieve a breast reduction at the same time. Using the SPAIR breast reduction skin pattern, the diseased tissues were completely removed by the general surgeon. As soon as she was finished the reconstructive surgeon came in and re-shaped the remaining breast tissue and re-draped the skin marked to leave behind, over the breasts. The result was an oncologic procedure that removed dangerous tissue from the breasts while reducing the volume of and lifting the remaining breast tissue. In one procedure cancerous tissue was removed and typical symptoms of large, ptotic breasts were addressed at the same time. The end result was a very pretty breast shape that for all practical purposes appeared like the patient had simply had a breast reduction!