Reduction mammoplasty for macromastia can promote the restoration of giant breasts to a normal state, with good cosmetic effect of the breasts after surgery. However, in actual clinical operations, reduction mammoplasty for macromastia still faces many technical difficulties, including key issues such as nerve protection of the nipple-areola complex, incision selection and incision healing. These factors directly affect the surgical outcome, so it is necessary to improve the overall treatment quality through strictly standardized surgical operations. In recent years, with the gradual deepening of clinical research, reduction mammoplasty for macromastia has made considerable progress, but there is still a lack of a systematic, scientific and overall effective treatment guideline. This lack of standardization may easily lead to postoperative complications, which in turn have a negative impact on the treatment effect and patient prognosis. This article mainly conducts an in-depth analysis on the research progress of incision selection and complications of reduction mammoplasty for macromastia, in order to provide theoretical basis and practical guidance for the optimization of subsequent clinical treatment work.