In 1991, based on the new concepts of the skin’s capacity to retract introduced by liposuction methods and peri-areola breast reduction and lifting, attentive to the emergent methods of video-surgery in many surgical fields, the author developed his research project to adapt Videoendoscopic methods to the subcutaneous territory and use it in plastic surgery for repairing rectus diastasis through minimal incisions, minimally invasive lipo-abdominoplasty/endoscopic abdominoplasty. In 1992 the author did is first case of breast lifting and after that, a few cases of endoscopic mastopexy. In 1993 started doing cases of endoscopic breast reduction and lifting with the aid of instrument designed himself for undermining the breast from the pectoralis, combining with video-laparoscopic and video-artroscopic instrument for resecting and reducing the breast tissue. In this chapter the author presents a critical evaluation of his personal technique “endoscopic breast reduction & lifting,” describing the technique step by step, the patient selection, the best indications, the goals and limitations of the technique, before and after and long-term follow-up with representative case out of a series of 220 cases done along these 30 years of using this technique. The author also compares the long-term results of the endoscopic breast reduction and lifting technique with the long-term results of similar cases operated by himself using others Breast Reduction and Lifting Techniques like Inverted T and peri-areola techniques, highlight the advantages of this minimally invasive keyhole endoscopic technique that preserves the breast function and sensation and leaves minimal and inconspicuous scars.