Breast ptosis means a disproportionate excess of the breast envelope in relation to its content and is a naturally occurring condition of the descent of nipple-areolar complex and breast tissue on the chest wall. Mastopexy is one of the most problematic procedures in aesthetic breast surgery because it is an operation of temporal value and has a purely cosmetic purpose so that the surgeon is able to minimize the scar, preserve the physiology and maintain upper breast bulging. Breast augmentation is th choice in small volume breast, but in case of adequate volume or to whom the breast implant cannot be applied, the lower pole tightening procedure or the internal suture-suspension to the higher position are indispensable to create upper bulging which is not possible by just removing excess skin,. The author combined the circumareolar approach and the internal suspension (Marchac, Lejour) to minimize scars, to make it versatile and to produce significant upper bulging. Series of 24 breast cases (12 women) were reviewed with mean follow-up of 8 months (ranges from 3 months to 2 years). All patients who had adequate volume or refused the breast prosthesis want to correct the breast ptosis. Most patients were satisfied with the shape and minimal scar of the breast after the circumareolar mastopexy without resection of breast tissue. The mean ascent of nipple-areolar complex was 5.6cm, the mean reduction of the distance between areola and inframammary crease was 3.0cm, and the mean amount of skin excision was 12.2 × 9.2 cm. Circumareolar mastopexy technique is a safe and easy surgical method and it provides an aesthetically acceptable scar and normal physiology with natural breast shape. This can be applied to the patient with minor to major breast ptosis and used to establish the new management protocol for each grade of ptosis which allows uniform and stystematic approach.