Few publications in the past have addressed specifically the effects of reduction mammaplasty in reducing symptoms associated with macromastia, and even fewer have surveyed patient satisfaction after reduction mammaplasty. This study investigates long-term results, morbidity, and patient satisfaction after reduction mammaplasty. A comprehensive questionnaire was sent to 296 patients who underwent reduction mammaplasty at Hamad Medical Corporation during the study period between January 1987 and December 1996. The response rate to the questionnaire was 55.4% on a single mailing. The charts of responding patients (164 patients) were reviewed retrospectively. The mean patient age at the time of surgery was 29.7 years, and the mean preoperative weight was 75.9 kg. Seventy-eight percent of respondents listed the relief of physical symptoms of large breasts as their primary motivation for surgery. An average of 1,037 g of tissue was resected per breast. Ninety-one percent of subjects realized improvement of symptoms and 65% were asymptomatic. The overall satisfaction rate was 67.6%, whereas 18.4% were dissatisfied and 14% were unsure. Minor complications that did not require further surgery were reported by 29% of subjects. Twenty-seven percent of respondents would have preferred to have more preoperative discussions with the surgeon, and 78% of subjects would recommend breast reduction to others.