The history of mammaplasty has been reported for several centuries, but there are few reports; therefore, it deserves careful study to understand the value of the surgeons who worked in adverse surgical conditions. Currently, breast reduction is a very frequent intervention in our country, but not in other countries. Numerous authors with their publications and papers presented at conferences and scientific meetings attest to its great importance. Surgery should be performed safely to reduce or even avoid complications that may be harmful to patients and surgeons. Mammaplasty aims to produce a breast with natural, proportional volumes and minimal scars and challenges the creative ability of the surgeons devoted to it and that seems to have no limits. There is no doubt that it is a constant challenge to the plastic surgeon and consists of a set of techniques or a combination of surgical maneuvers that enriches the medical literature. Among them, we can mention some that have become classic, such as the skin incision marked in a W shape; peri-areolar de-epithelialization or Schwarzmann’s maneuver; the longitudinal fusiform infra-areolar incision, oblique and/or transverse; undermining and incisions of the adipose–glandular tissue at the base of the breast; and the use of various types of areolar and de-epithelialized flaps with proximal, distal pedicle, and superomedial and superolateral to transpose the nipple–areola complex (NAC).