There are several factors to be considered while performing reduction mammoplasty in patients having giant breast with severe breast ptosis. These are degrees of breast ptosis, location of newly created nipple areolar complex, preservation of sensation, symmetry of both breasts, amount of breast tissues to be resected, and finally the postoperative scar. Among the above factors, postoperative scar seems to be the major problem that patients complain about. So several methods have been investigated in time to minimize the scar.
  Authors have performed 3cases of reduction mammoplasty in patients with severe ptotic large breast by applying the method of umbilicus creation in abdominoplasty, so that only periareolar and submammary scars remained without a vertical scar. The age were between 33 and 43 years old. Mean follow up period was about 6.5 months. Amount of the resected mammary tissues was about 750-1350g. Periareolar deepithelialization was made about 8cm diameter for better circulation to the nipple areolar complex and wider contact area thus enhancing the stabilization and survival of the nipple areolar complex. Only 1 case with partial deepithelialization of the areola occurred but completely healed within 1 month. Patients were pleased with natural shape and size of the breast and the sensation of the nipple areolar complex was restored completely in all cases after surgery.
  Authors have performed reduction mammoplasty without leaving the vertical scar which considered to be the major problems of the classical methods. Other problems such as insufficient reduction, flattening of the breast and severe wrinkles around the nipple were also solved. This method not only improve the aesthetic importance but also minimize the functional complications such as sensory loss and difficulty in lactation.