A retrospective study was undertaken to evaluate the long-term results of reduction mammaplasties. Of special interest was the extent to which the amount of breast tissue removed correlated with pain relief after reduction mammaplasty. One hundred fourteen patients underwent an average reduction of 1,266 g. The follow-up time was 7.7 years. Ninety-one percent of the patients noticed a decrease in shoulder, neck, and back pain, and lessening of brassiere shoulder grooves. Nine percent noticed no change at all, and only 1 patient complained of increased breast pain after the operation. In 11% of the patients, pain was not an indicator for the operation. We could find a significant correlation (r = 0.36, p = 0.001) between the amount of tissue resected and pain relief after surgery. The follow-up time did not correlate with a regaining of the physical complaints (r = 0.15, p = 0.2). Patients gained an average of 1.2 kg and had an average preoperative overweight of 118%. From the results of our study we were able to conclude that an average reduction of 500 to 600 g of breast tissue on both sides has a long-lasting effect in reducing shoulder and back pain.