This study is to compare a tissue adhesive, 2-octylcyanoacry-late (Dermabond(R)), with conventional wound closure techniques for vertical reduction mammaplasty. Twenty patients presenting large breast from November to December 2005 were enrolled into this prospective clinical trial study. These patients breasts were randomly assigned to treatment with either 2-octylcyanoacrylate or 5-0 monofilament sutures. Photography taken at six months after treatment were rated by two plastic surgeons and six layper-son blinded to the method of closure. There was no significant difference between the two groups for appearance scores based on a visual analog scale(81.9mm for 2-octylcyanoacrylate versus 75.7mm for 5-0 monofilament sutures). The length of time for periareoalr repair was decreased in the 2-octylcyanoacrylate group(2.7 minutes for 2-octylcyanoacrylate versus 8.3 minutes for 5-0 monofilament sutures, p<0.001). The patients satisfaction rate in the 2-octylcyanoacrylate group was high. Moreover, the use of 2-octylcyanoacrylate obviates the need for suture removal. In conclusion, the use of 2-octylcyanoacrylate for vertical reduc-tion mammaplasty is an acceptable alternative which includes several advantages to conventional suturing with a comparable cosmetic outcome.