In the past 20 years, patients have become more critical about the result of a breast reduction operation. Natural lasting shape and minimal residual scarring are now expected by most of the candidates to that surgery. In 1969 the author described a vertical technique that achieved reduction and good shape but the end of the vertical scar could be seen below the brassiere line. In 1977 the author modified the technique by adding a small horizontal scar that eliminated the visible part of the vertical scar. In this article the author demonstrates that the same technique he described in 1969 and modified in 1977 can produce a single residual vertical scar if properly used.