Background Short-scar breast reduction techniques have become very popular in the last two decades. These techniques cannot be used very often in patients with exceptionally large breasts because of the excessive amounts of redundant skin. In this article we describe our newapproach for dealing with the extra skin remaining in patients with very large breasts so that they may also benefit from the short-scar breast reduction procedure. Methods In our technique the vertical suture line is divided into two separate suture lines. The first suture line follows the natural curve of the lower pole of the breast from the nipple to the chest wall. This line is elongated by elevating and anchoring the new inframammary fold higher on the chest wall with a suspensory suture and the skin is then closed in a straight line. The second suture line attaches the extra lower skin by closing the dermis to the chest wall and then closing the skin with a purse-string suture. This technique helps to deal with the extra skin resulting from the short-scar breast reduction technique. Results The technique was used in ten patients with large breasts. Patient satisfaction was excellent and there was no increase in complications. The technique also helped to obliterate the dead space beneath the breast and reduced seroma formation. Conclusion We found that this new technique can be used safely and effectively in selected patients with large breasts without any increase in complications. Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.