The ideal procedure for reduction mammoplasty should: (a) create a breast of desired size with an aesthetically pleasing shape; (b) leave small "invisible" scars; (c) preserve the nursing capacity; (d) leave the erotic sensibility intact; and (e) have no postoperative complications. Most of the unfavorable results can be avoided by careful preoperative planning and restrictive patient selection, with special attention being given to very young patients and to those with unrealistic expectations.