The concept of the author's technique foresees that the long-term appearance after reduction mammoplasty is dictated by the volume and shape of the remaining glandular adipose tissue, on which the skin gradually contracts. The resection of this tissue obeys the same orientation for small, medium, and large hypertrophic breasts. The design for skin resection is chosen according to the quality and quantity of the skin to be removed. Three different designs are presented.