Introduction: To achieve a rounded breast shape and ensure longer-lasting positioning in mammoplasty, we combined the Costa Lima technique with the Ribeiro technique by anchoring the flap to the pectoral muscle. Objective: To evaluate the breast shape and positioning five years after surgery using the combined Costa Lima and Ribeiro techniques. Method: We made a very thin upper flap measuring 2 cm using the Costa Lima technique corresponding to 30% of the final volume of the breast and a bulky lower Ribeiro flap fixed to the fascia of the pectoralis major muscle, corresponding to 70% of the volume, mimicking a silicone implant and preserving breast positioning for longer. Result: Three plastic surgery specialists evaluated the five-year photographs and concluded that 93.2% had excellent maintenance of the positioning and projection of the upper pole. Conclusion: We conclude that this association of techniques promotes a result similar to that of silicone implants and with greater durability of positioning.