Vertical scar breast reduction with medial flap or glandular transposition of the nipple-areola

Vertical scar breast reduction is a well accepted technique which we believe improves the shape and projection of the breast and leaves no horizontal scars. Lassus and Lejour described superiorly based nipple flaps; we describe a medially based flap or glandular transposition of the nipple in small reductions. Fifty-seven consecutive patients are presented. Thirty-three patients had medial transposition of the nipple-areola with a mean resection of 608 g (range 220–1250 g). Twenty-four patients had a glandular transposition of the nipple-areola, with a mean resection of 380 g (range 220–600 g); transposition of the areola should be less than 5 cm in this group. After a short learning curve, the complications have been few and minor.