The planning approach for augmentation mastopexy with an implant must take into account a series of factors that will act together to determine the new shape, volume and positioning of the breasts. The type of support method used and the quality of the skin and tissue implant protection are fundamental points for reducing the occurrence of unsatisfactory results, such as late inferior bulging (“bottoming out”) and other more severe ones, such as implant extrusion. The augmentation mastopexy technique with preservation of the dermis “dermal strap” aims to promote an external protection barrier for the breast implant with consequent prevention of extrusion, as well as to act as an auxiliary factor to reinforce the postoperative support mechanism of the breast. The technique is succinctly described as not completely resecting the “excess” skin. Instead, a skin decortication is promoted, with subsequent invagination – internal plication of the decorticated dermis in order to act as an internal cushion to give more protection to the implant, increasing tissue resistance and reducing the chances of deformation of the lower pole acting as a complementary method of support and protection to prevent the occurrence of implant extrusion. After a consistent series of cases operated with this technique over more than 10 years, parameters of shape maintenance, degree of residual ptosis (“bottoming out”), scar quality, risk of extrusion, and other complications were evaluated. Satisfactory maintenance of results was observed, with adequate shape and low degree of inferior bulging (“bottoming out”). There were no reported implant extrusions. The main complications are partial dehiscence and cicatricial enlargement, which can be fixed by subsequent surgical scar revision or resuture in the office under local anesthesia. The technique is easy to perform and reproducible, with savings in skin resection and reduction of the resulting scar compared to what was initially planned. The technique was effective in preventing extrusion, since even in cases where there was great suture dehiscence, the protection of the dermis stunts the external contact to the implant. The technique proved to be a valuable option to the various existing approaches, as one more useful tool in the surgical arsenal, in order to reduce the problems described in the augmentation mastopexy procedure with an implant.