In the last decade, entirely new techniques in breast reduction and reconstruction have evolved. What remains unclear is whether or not these new procedures, some of which carry additional surgical risk and cost, are superior from a patient perspective. Thus, plastic surgeons are ever more reliant on clinical research to provide high-level evidence to facilitate clinical decision-making, as well as policy negotiations and advocacy. This article provides an overview of the strengths and weaknesses of different study designs, the appropriateness of various outcome measures, and the importance of establishing a strong evidence base in breast surgery.