Background: In the literature, many techniques have been described for use in reduction mammaplasty. Some authors emphasize the importance of the final breast shape; others focus on the size of the incision, whereas some authors draw attention to both the shape and the size of the incisions. In this study, the author describes the use of a single central block of the mammary tissue and the nipple–areolar complex (NAC) on its top dissected from the skin flaps and chest wall, and based on the superior vascular pedicle for reduction mammaplasty and mastopexy. Methods: A retrospective study was performed, evaluating patients who underwent breast reduction and mastopexy using the single central block technique from July 1985 to December 2022 by a senior author. Results: A total of 2298 procedures were performed using this technique, and 1713 of them were reduction mammoplasties and 585 mastopexies. The mean age was 46. The mean weight of tissue resected was 449 grams. Fat necrosis on the distal area of the flap was observed in 47 cases (2.04%). Hematoma was observed in 6 patients (0.26%). Surgical revisions were undertaken in 86 patients (3.74%). Hypertrophic scars occurred in 13 of the cases (0.56%). Dehiscence in the inverted “T” scars occurred in 85 of the surgeries (3.69%). Conclusions: This technique allows the surgeon to easily form a good cone shape of the breast, repositioning the NAC and preserving its vascularization and sensation, without tension on the skin flap sutures, resulting in smaller and better scars.