Objective To explore the effect of vertical incision medial pedicle breast reduction plastic surgery on breast lifting effect in female patients with breast hypertrophy. Methods A total of 80 female patients with breast hypertrophy admitted to the Department of Medical Aesthetics, East Campus of Hebei Yiling Hospital from January 2023 to January 2025 were selected as the research subjects. According to the random number table method, they were divided into the control group and the study group, with 40 patients in each group. The control group underwent inverted T-incision breast reduction, and the study group underwent vertical incision medial pedicle breast reduction plastic surgery. The breast lifting effect, clinical related indicators, quality of life and complication rate were compared between the two groups. Results At 3 months after surgery, the indicators related to breast lifting effect in the study group were shorter than those in the control group (P<0.05). The amount of unilateral resection tissue and intraoperative blood loss in the study group were less than those in the control group, the scar height was lower than that in the control group, and the scar length was shorter than that in the control group (P<0.05). At 3 months after surgery, the scores of all quality of life indicators in the study group were higher than those in the control group (P<0.05). The incidence of complications in the study group was lower than that in the control group (P<0.05). Conclusion Vertical incision medial pedicle breast reduction plastic surgery has multiple advantages in the treatment of breast hypertrophy. While reducing intraoperative trauma, it can decrease the risk of postoperative complications, achieve the comprehensive effects of shorter scar and more natural breast lifting effect, and ultimately improve patients' quality of life.