First, your doctor will discuss your goals with you and explain what can realistically be achieved. We should take into account your hip size when determining your new breast size. Removing too much breast tissue will make your hips look large by comparison, giving you a pear shape. Obviously, you can request significant removal, although you may want to consider this balance when determining your end size. Prior to your breast reduction surgery, a complete medical history is taken to evaluate the general health of the patient. The breasts are then examined thoroughly to determine the most effective surgical approach. Mammograms or x-rays may be taken along with preoperative photographs. You may also be instructed to have blood tests performed, which may include a complete blood count (CBC), a pregnancy test, clotting tests, and others.