The use of vertical-scar breast reduction techniques is only slowly increas
ing, even though they have been advocated by Lassus and Lejour and are requ
ested by patients. Possible reasons why surgeons are reluctant to use these
techniques are that they are said to be more difficult to learn, they requ
ire considerable experience and intuition, and their applicability is confi
ned to small breasts. Several surgeons have developed modifications, combin
ing vertical-scar breast reduction techniques with details of the familiar
inverted-T-scar technique. We present a procedure involving two further mod
ifications of the vertical-scar breast reduction technique: first, a standa
rdised, geometrical preoperative drawing from our superior-pedicle T techni
que, with the aim of establishing a reproducible method of reduction requir
ing no particular intuitive touch, and, second, the addition of a periareol
ar skin resection, to give the breast the desired round shape. Between Sept
ember 1998 and December 1999 we used this technique in a prospective series
of 52 patients. The median resection weight was 450 g. The maximal postope
rative follow-up was 15 months. There were no acute postoperative complicat
ions necessitating reoperation. The late complication rate was within the e
xpected range for such procedures (seven patients, 13.5%) and included vert
ical-scar widening, areolar distortion, residual wrinkles due to incomplete
shrinkage of the undermined skin in the inferior pole and asymmetry of the
breast. This procedure enables us to offer patients with moderate to marke
d hypertrophy a reproducible versatile vertical breast reduction technique.
The technique is easy to teach and easy to learn, especially for those who
are familiar with the superior pedicle inverted-T-scar technique. (C) 2001
The British Association of Plastic Surgeons.