Mastopexy patients are generally concerned with cosmetic results, which makes the procedure challenging. In addition to recreating a young and firm breast, one of the main concerns is to reduce the extent of the scars. The authors were the first to report in the literature its combination with the owl technique with a lower pedicle in mastopexy in 2007. The authors have used the combination of both techniques since 2004 for the treatment of patients with breast ptosis with or without breast hypertrophy. However, over time the indications expanded to the treatment of breast asymmetries, breast implant explantation, breast tuberous deformity, and symmetrization of a contralateral breast in the context of breast reconstruction for breast cancer. The combination of techniques presented seems to be an excellent option for aesthetic and reconstructive treatment. It allows correction without compromising the vascularization or innervation of the NAC, as well as the symmetrization of a contralateral breast in the context of breast cancer reconstruction with shorter scars and lasting results.