The vertical breast reduction is the most common type of breast reduction performed in our practice and involves a scar around the areola and in a vertical direction beneath the areola down to the crease under the breast. This “lollipop” shaped scar allows exposure to the underlying breast gland to adequately shape and sculpt the breast mound. Additionally, closure of this vertical incision allows the breast “pillars” to be sutured together in the midline which creates additional projection and support to the breast mound independent of the overlying skin. The vertical breast reduction most commonly utilizes a superior or medial-based pedicle which means that the blood supply comes from the upper portion of the breast or from the portion closest to the sternum. The advantages to the vertical breast reduction include excellent breast shape, projection and long-term results. The disadvantages of the vertical breast reduction include significant breast projection (some people do not desire this) and the fact that the surgical result on the operating table does not look like the final result which will be seen in 3-4 months. Another potential disadvantage to the vertical mastopexy is the fact that skin is not removed in the horizontal plane and tightening of these tissues may take 4-6 months. The other advantage to the vertical mastopexy is that it avoids the transverse or “anchor” shaped scar.