Objective To evaluate the implication and necessity of deepithelialization in mastopexy. Methods A total of 124 patients with mastoptosis were randomly divided into 2 groups: group Ⅰ and group Ⅱ, 62 cases each. A double-circle incision technique was used for all the patients. In group Ⅰ, full thickness skin around nipple-areola was resected. While in group Ⅱ, deepithelialization was performed and the peri nipple-areola dermis was preserved. Results The average full skin resection time was 4.5 minute per side in group Ⅰ and the skin deepithelialization time was 15.8 minute per side in group Ⅱ. Postoperative follow-up was carried out for all the 124 patients with duration of 2 weeks to 4 years. In group Ⅱ, sebaceous cysts, epidermal inclusion cyst and suture knot exclusion were found at the incision site in 8 patients (12.9 %) at 3 weeks to 1.5 years after operation. Conclusions The blood supply to the nipple-areola complex is not affected by full-thickness skin removal during mastopexy, while the incidence of complication at the incision site decreases significantly. We conclude that deepithelialization has not much clinical significance in mastopexy. Key words: Mastopexy; Incision; Complications