Subpectoral augmentation mammaplasty through umbilical approach has several advantages including minimal scarring, remote incision, rapid recovery and little pain. The purpose of this article is to describe in detail the authors' transumbilical technique and provide indications for subpectoral augmentations and important surgical tips. 86 patients(n=172 breasts) who underwent subpectoral transumbilical augmentation from April of 2003 through October of 2005 were evaluated. Complications included local inflammation on umbilicus due to previous piercing(1 case), hypertrophic scar(1 case), partial superficial slough on umbilicus (1case) and capsular contractures (3/86, 3.5%). But there was no breast infection, hematoma, and the need for a change to other incisions, intraoperatively. The majority of these complications occurred early in the learning curve. All patients were satisfied with the results. The ideal indication of this procedure is the cases of adequate thickness of lower portion, no ptosis, no lower pole constriction and relatively long distance from nipple to inframammary fold. Based upon these results, transumbilical subpectoral breast augmentation is believed to be a safe alternative technique with fewer complications.