PURPOSE: Inferior pedicle reduction mammaplasty techniques have been limited by a tendency for “bottoming-out” and “boxy” postoperative appearance. We present a novel technique using dermal ‘flaps' to provide long-term maintenance of vertical height and anterior projection.

METHODS/TECHNIQUES: We reviewed our series of forty-five patients who have undergone this technique. Standard Wise pattern markings are performed preoperatively. After the central breast mound is created, de-epithelialized dermal “flaps” are fashioned and wrapped around the central breast mound and sutured. This is then suspended to the anterior pectoral fascia with permanent suture. Anterior plication of the pedicle dermis is performed to direct final nipple position and modify breast projection. Superior flaps are re-draped over the breast parenchyma. We have also employed this technique eliminating the vertical scar.

RESULTS: Forty-five patients have undergone this technique. Breast height and anterior projection have been maintained with follow-up beyond 4 years. We have not noticed “bottoming-out”, scar widening or delayed wound healing. Projection of the breast is maintained with the patient supine.

CONCLUSIONS: We present this technique as a novel approach to correct many of the recognized limitations of traditional reduction mammaplasty techniques. Vertical height and anterior projection are enhanced through the support of non-prosthetic dermal “flaps”.