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Total mastectomy is the most common breast surgery performed for breast cancer in developing countries. In most of these mastectomies, the Stewart’s or the Orr incisions are utilized, however the resulting scars from these traditional incisions are conspicuously centred across the anterior chest and the resulting scar may not be aesthetically satisfying. Our vertical mastectomy technique with lateral wound closure, utilizes anterior-medial and posterior-lateral skin flaps which are sutured in the anterior axillary line, extending transversely into the inframammary fold. This provides an elegant closure with no visible scar lines in the centre of the ipsilateral chest. The technique can be utilized for non-T4 tumors in all quadrants of the breast and for unifocal T4-tumors involving the outer quadrants, once it is possible to sufficiently laterally displace the nipple-areolar complex. Here we describe the first utilizing this technique for a patient with metastatic breast cancer with an uncontrolled primary.