The evolution in the last 15 years of a personal technique for reduction mammaplasty is presented. First, the periareolar pedicle is marked, and then the inferior pole, where three types of marking are possible: type 1—linear vertical marking; type 2—oblique fusiform marking; type 3—transverse fusiform marking above the submammary fold, which with the periareolar marking is similar to a cyclops figure. The technical sequence is as follows: (a). The handling of the pedicle. (b). The reverse flap procedure when indicated. (c). The breast resection and (d). The closure that begins in depth using centralizing sutures. The most important advancement was the development of a reverse flap in the inferior pole to improve a high and hypotrophic submammary fold. This flap corresponds to a lower half of the transverse fusiform resection at the inferior pole. This flap is rotated posteriorly and inferiorly to fill the submammary fold. Nowadays, this flap procedure is performed in patients with breast hypertrophy and ptosis, associated to a submammary fold atrophy.