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I would strongly recommend that you do under general anaesthesia, when you are trying to get a breast reduction surgery under local anaesthesia is technically demanding for the surgeon and anaesthetist and it is much uncomfortable for the patient I would recommend to get it done under general anaesthesia. Yes general anaesthesia seems scary. Today anaesthesia has advanced in so many bounds and leaps. The first thing is we need to decide if we have to undergo a surgery or not. How is it decided is to see the way you look and if you feel they are too big, then the surgery is required. The breast starts from about 2 to 3 fingers outside the breast bone, go all the way upto the anterior axially fold or the fold near your axilla and it extends from clavicle one to the lower part of the rib cage. From there the breast comes forwards and downwards and depending on the kind of figure you have and you like to have, you may feel your breasts are too big. In that case you can have consultation with the plastic surgeon and he will tell you if your size is too big. Others are your friends and family who wilt el if your breasts are disproportionately large. You may nor may not be the right judge for it. So it is always good to take a second opinion from family and friends. The next thing is breasts are not in a normal line. Typical youthful looking breast is where the nipple areolar complex lies in the mid arm level. This is easily made out if you stand in front of the mirror, and look at yourself, your shoulder erect an head erect and if you find your nipple areolar complex is below the mid arm line, that means your breasts are sagging an you may have ptosis or maybe your breasts are too big for our own physique. Then it is better to take opinion for your plastic surgeon who will exiane you and tell if your breasts are large and if you need a reduction surgery.