Background: Breast ptosis is one of the most common complaints in the clinical setting. Simultaneous mastopexy via areola excision involves a reliable modified aesthetic technique with distinctive features to correct mild and moderate pendulous breasts. The aim of this study is to determine whether the novel surgical approach is a safe and long-lasting technique for patients with breast ptosis. Methods: We performed a retrospective study of 48 patients who received simultaneous mastopexy through circumareolar excision and followed up for 12 months. Breast size, shape, fullness, symmetry, scar appearance, and sensitivity of nipple-areolar complex were evaluated. Results: Patients were satisfied with upper pole fullness, symmetry and scar less appearance. There were no cases of NAC deformity or sensation loss, neither sever capsular contracture was observed. Conclusion: The new surgical technique, one-stage periareolar augmentation mastopexy, is a reliable and long-lasting operation for patients with mild and moderate breast ptosis. Level of Evidence IV: This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. © 2020, Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery.