The goals of reduction mammoplasty are to remove the appropriate amount of breast tissue and to make the nice cone-shaped breast. For these goals, various methods have been used and newly introduced. Recently, as women's interest in cosmetic attractiveness increases, surgeons make attempts to minimize postoperative scars. Periareolar approach has an advantage of invisible postoperative scar, but has many disadvantages - flattening of breast shape, recurrence of breast ptosis, hypertrophy and widening of periareolar scar, enlargement and distortion of areola caused by tension. After Benelli introduced Round block technique, this approach became one of the most popular methods. The characteristics of Round block technique are periareolar approach, superiorly based dermoglandular pedicle, criss-cross mastopexy, and Round block suture. Authors modified periareolar Round block technique to adjust to Korean women and have operated on 11 patients since 1997. We focused on medializing the lateral portion of inframammary fold and avoiding asymmetry and protrusion of nipple-areolar complex. Round block suture with uniform thickness and length must be applied at the same time to prevent areolar complications. In design, authors referred to the statistical analysis on Korean female. The results are aesthetically and functionally satisfactory and there has been no significant complication. In conclusion, this method is effective for young woman or mild macromastia with moderate ptosis. Besides, an accurate understanding of each step of operative procedure and enough knowledge of anatomy and physiology of the breast are essential.