【摘要】 目的 探讨垂直上蒂法乳房缩小整形术在治疗巨乳症中的改良应用。 方法 2007年1月-2009年10月对18例乳房肥大患者行垂直上蒂法乳房缩小整形术，设计乳晕下做垂直切口，乳房下皱襞上1～2 cm做弧形切口;乳晕上新乳头区域去皮制皮下蒂，切开形成左右两侧皮瓣，乳头乳晕垂直向上折叠缝合于新乳头位置，逐步分次去除多余皮肤及乳腺组织，不悬吊固定切除后的乳腺组织，向中央收紧乳房，获得轮廓饱满、曲线圆滑的新乳房。 结果 手术效果良好，乳房外形饱满，轮廓曲线圆滑，随访半年后乳头乳晕感觉恢复良好，切口瘢痕小，患者满意。 结论 此改良法治疗中重度巨乳症术后乳房形态效果满意，设计与手术操作简便，值得推广。【Abstract】 Objective To explore the improved application of vertical superior pedicle breast reduction mammaplasty in macromastia treatment. Methods Between January 2007 to October 2009, arc incision above submammary fold 1 - 2 centimeters and vertical incision through inferior mammary areola were designed.New mamillary region skin superior mammary areola was deepithelialized and formed subcutaneously pedicle.Mammary areola and nipple subcutaneously pedicle were vertically upward plicating sutured to form new nipple area, the redundant skin and mammary gland were gradually excised, and obtained a new saponaceous curved mammary. Results Totally 18 cases (36 mammaries) were performed by this method.After 6 months’ follow-up, the results showed that new mammaries had good shape, saponaceous outline and little scar in incision, sensation on mammary nipple and areola recovered.All patients were satisfied with the postoperative results. Conclusion Improved vertical superior pedicle breast reduction is an ideal breast reduction method for moderate and severe macromastia, and the technique is convenient in design and operation.