Reduction mammaplasty can provide symptomatic relief to patients suffering from macromastia, however complications such as dehiscence are common. It is unknown if the presence of complications may affect patient reported outcomes. This study aims to (1) determine risk factors for development of complications, and (2) to examine the correlation between postoperative complications and patient reported outcomes in reduction mammaplasty. A single-center retrospective chart review was performed on patients who received reduction mammaplasties (CPT19318) between 1/17-2/23 by thirteen surgeons. Breast cancer cases and oncoplastic reconstructions were excluded. Patients with >1 complication were grouped into the complications cohort. BREAST-Q-survey was used to assess satisfaction. A total of 661 patients were included for analysis, and 131 patients developed at least one complication. Patients in the complication group had significantly higher average ages and body mass indexes, and a higher likelihood of hypertension and diabetes (p<0.01). Among 180 BREAST-Q responders, 41 had at least one complication. There were no significant differences between the two groups across survey outcomes. Although obese patients were more likely to develop infection and require revisions (p<0.01), no significant differences in subgroup analysis of patient-reported outcomes focusing on obese patients were observed. Obesity, hypertension, and diabetes were associated with postoperative complications of reduction mammaplasty. Patients with complications had similar postoperative Breast-Q satisfaction to patients without complications. While risk optimization is critical, patients and surgeons should be reassured that satisfaction may be achieved even in the event of a complication.