Reduction mastoplasty is a very common procedure in plastic surgery. Nowadays, there are several techniques described in the medical literature through which it is possible to achieve outstanding aesthetic results with a very high rate of patient satisfaction. We described a technique creating a dermal–subcutaneous flap with its base on the submammary fold, which offered good support to the breast. The dermal–adipose flap is drawn during surgical marking. The flap is introduced and sutured under the remaining mammary parenchyma after resection to avoid any sloughing of the junction of the inverted T scar. The final scar is located peri-areolar and on the infra-mammary fold. Surgical planning and markings are mandatory steps before operation. We prefer to demarcate the patient in a standing or sitting position to mark the sub-mammary crease where the horizontal segment of the inverted T scar will be located.