Background Current mastopexy techniques rely on incisions on the breast to correct ptosis. Trading a ptotic breast for a visibly scarred breast can be a difficult choice. Objective and Methods A technique of internal suture mastopexy that consists of plicating sutures placed in the superficial fascia of the breast from the deep surface is presented. The procedure leaves no scar on the breast and may be safer than other techniques when combining mastopexy with augmentation. Results The senior author has performed this procedure on over 120 patients, with a mean follow-up of two years. Patients and the surgeon have expressed satisfaction with the procedure. Conclusion Based on this experience with over 120 patients, the authors believe that internal suture mastopexy is an effective alternative in selected patients.