Since the beginning of my practice, I have sought to minimize the final scar on the submammary crease without compromising the shape of the breast. One should not prioritize achieving smaller scars at the expense of breast form, harmony, and symmetry. The operation is performed under local anesthesia combined with intravenous sedation under the care of an anesthesiologist. A pre-demarcation is done one day before the operation. My technique is derived from Pitanguy’s method, with several surgical modifications introduced to further reduce postoperative scarring. Pitanguy’s point “A” remains the key reference for surgical markings. In my approach, points “B” and “C” are marked significantly lower than in the original technique—an essential adjustment to minimize the extent of skin resection along the submammary crease. Glandular resection follows Pitanguy’s “keel” concept, creating two columns and incorporating a “third pedicle.” Rather than removing excess skin via a horizontal incision at the submammary crease, it is excised through the vertical incision by pulling the skin forward. In my concept, the internal and external skin of the breast mirrors the two columns formed during glandular resection. The cutaneous suture is done with internal stitches. There is no “dead space” and no bleeding during surgery and no drainage is used. The rate of complications has been very low.