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We evaluated instances of patients with level III ptosis which underwent a staged repair method with reduction mammaplasty followed closely by NSM and instant reconstruction with an abdominally based free flap (2014-2019). We compared this set of patients to an extra group who underwent staging with a technique of nipple-areola complex (NAC) devascularization. A survey ended up being administered to assess for patient satisfaction and visual outcome 1 year following the 2nd staons while addi