During a three year period, 242 women ranging from 16-68 years with hypertrophic breasts underwent reduction mammaplasty by Skoog's, Strömbeck's, Regnault's, or the nipple-areola transplantation technique. After a follow-up period of three years the results were evaluated by requesting the patients to complete a questionnaire and also by abstracting information from the records. The most common preoperative symptoms were pain in the head, neck, and shoulder-region, sufficient to cause a working disability in approximately half of the patients. Psychological distress regarding appearance was more common among the younger women. The mean weight of the removed tissue was 1184 g (SD 583), which correlated positively with both increasing age and body mass index (BMI). The overall complication rate was 10%, which also correlated positively with BMI. The postoperative evaluation indicated that 86%-96% of patients experienced relief of symptoms postoperatively and 92% of the total number of patients were satisfied with the operation. Approximately three quarters of the women who had a working disability prior to the operation were able to return to their former occupations postoperatively.