Deepithelization of the breast in breast ptosis surgery is important, being associated with risks which could affect the clinical outcome. The role of Er:YAG laser deepithelization was investigated. A total of 12 bilateral mammoplasties were performed, randomly assigned to 2 groups, one of experienced and one of less-experienced surgeons. Results were compared between the 2 groups of surgeons for scalpel deepithelization on one breast and the Er:YAG laser on the contralateral breast. No complications; less edema, pain, and erythema; and quicker wound healing were observed in the laser-deepithelized breasts, with a shorter operation time even for the less-experienced surgeons. The authors do not suggest that the Er:YAG laser should replace the scalpel in the hands of the expert surgeon for breast deepithelization in breast ptosis surgery, but the results of the study suggest that Er:YAG laser ablation is a safe, precise, effective and complication-free method.