Reduction mammoplasty is one of the most common procedures performed by plastic surgeons. Surgeons select the technique that best suits each patient based on the surgeon’s experience, specific patient characteristics and requirements. The purpose of this article is to report the complications that occurred in patients who underwent reduction mammoplasty at our institution, and to compare our data to the current literature. We studied the postoperative complications from 82 breast reductions (41 patients), which used superior pedicle (n = 6), inferior pedicle (n = 36), medial pedicle (n = 10) or Thorek (n = 30) techniques. The most common postoperative complications were hematoma (7%), seroma (2.5%), delayed wound healing (14%), partial nipple loss (4.8%), infection (10%) and asymmetry (12%). We observed complications in 64% of patients that underwent inferior pedicle breast reduction with an inverted T scar. One possible explanation for this complication rate is that inferior pedicle Wise-pattern mammoplasty is usually performed for breasts with sternal notch-tonipple distances greater than 32 cm, or for symptomatic macromastia, and greater amounts of resected tissue are known to be associated with higher complication rates. Nevertheless, this technique is associated with excellent patient satisfaction. Indeed, complications are quite frequent and may occur even in the most suitable candidates, but do not compromise the final result.