Breast reductions are a very common procedure within the field of plastic surgery with many techniques. These techniques include differences between the location of the pedicle and variations in scar location. Another variation on the technique for breast reduction relates to preoperative infiltration of an epinephrine solution to reduce blood loss and operative time. Our technique for breast reduction and its effect on insurance reimbursement has not previously been discussed in a large prospective study. We performed a prospective study to compare a cohort of 50 patients undergoing a traditional breast reduction without infiltration of epinephrine followed by electrocautery for resection versus 50 patients receiving tumescent infiltration of epinephrine followed by sharp resection. Overwhelmingly, the patients that underwent the tumescent technique for breast reduction had shorter operative times, less blood loss and less pain. The use of tumescence did not cause a significant difference in the weight of the amount resected when compared to the dry, pathology weight. In the first large prospective cohort study involving this technique, we can demonstrate the many advantages of the tumescent technique and refute our concern that tumescence can cause inaccurate weight measurements that might interfere with insurance reimbursement based on resected weight.