The association of breast reduction with the use of silicone prostheses has been a trend among surgeons. The explanation for this choice would be the improvement in shape and more support of the breasts, in addition to greater firmness, with the use of the silicone prosthesis claiming a longer period of maintenance of the result. With the knowledge of BIA-ALCL, CCE, ASIA syndrome and silicone diseases, the use of silicone prostheses exclusively for breast augmentation and breast reconstruction started to be considered as the only indication for its use. From 2019 to 2022, we operated 225 female patients, aged between 18 and 56 years, underwent bilateral reduction mammoplasty with the creation of an organic prosthesis. The creation of an inferior flap type IV by Ribeiro, Liacyr, already described previously and by other authors, projects the upper pole of the breasts very well. The organic prosthesis is made from the separation of the breast tissue, exactly on the line between points B and C of the inverted T technique. The incision runs parallel to the pectoral muscle to the upper pole of the breast, creating a small cone in the shape of points A, B and C and a volume of breast tissue and fat fully connected and adhered to the pectoral muscle. With an X suture with 2-0 nylon, we proceeded to fix the upper and lateral edges of this flap created, creating a structure identical to a silicone prosthesis. The tissue cone held superiorly, when assembling the breast, brings maximum projection to the structure of this new breast. The organic prosthesis technique described simulates the placement of a silicone prosthesis implant, mainly in reduction mammoplasty. It can be a great alternative for mammoplasty, bringing results like the use of silicone prosthesis. Its advantages are the absence of diseases related to silicone prosthesis and the lack of need for future replacement. 

Augusto Valente has 27 years of experience in plastic surgery, is a Titular member of the SBCP (Brazilian Society of Plastic surgery), an international member of the ASPS and an active member of the ISAPS, and is the Deputy Regent of the Plastic Surgery Chapter of the SBCP.