Symptomatic relief of macromastia following reduction mammaplasty in the adult female population is well documented. Teenagers undergoing breast reduction may be at risk for recurrent symptoms secondary to postoperative breast development. The psychological consequences of prominent scars, sensory loss, and inability to breastfeed may overshadow the early symptomatic relief gained from reduction mammaplasty. Eighty-six patients who had undergone bilateral reduction mammaplasty prior to 20 years of age from 1970 to 1990 were identified from hospital and office charts. Forty-eight patients (56%) were successfully contacted and completed a detailed questionnaire evaluating preoperative, postoperative, and present symptoms as well as physical and psychological consequences of their surgery. Patient age ranged from 15.0 to 19.9 years with a mean of 17.8 years. Average length of follow-up time was 5.9 years, ranging from 1.4 to 20.4 years. Sustained relief of symptoms in those patients with preoperative back pain, neck pain, shoulder strap pain, and submammary rash occurred in 76%, 78%, 89%, and 93%, respectively, despite the fact that 72% reported at least some regrowth of breast tissue. Seventy-three percent reported being happy with their current breast size, 94% would have the procedure now if they had not had the surgery as teenagers, and 94% would recommend breast reduction to a friend with macromastia. Teenage patients who undergo reduction mammaplasty do not suffer from marked return of symptoms, and long-term satisfaction remains high.