Objective To investigate the clinical efficacy of double-loop and vertical double-pedicle breast reduction in the treatment of patients with macromastia. Methods A total of 70 patients with macromastia who underwent breast reduction plastic surgery in the Department of Plastic and Aesthetic Surgery of Chongqing Huamei Plastic and Aesthetic Surgery Hospital from June 2023 to June 2024 were selected as the research objects. According to different surgical methods, they were divided into control group and observation group, with 35 patients in each group. The control group was treated with double-loop breast reduction plastic surgery, and the observation group was treated with vertical double-pedicle breast reduction plastic surgery. The breastrelated indicators, scar conditions, clinical efficacy, complications, quality of life and satisfaction were compared between the two groups. Results The breast shape score, areola diameter and nipple areola sensation score of the observation group were better than those of the control group (P <0.05). The SCAR score of the observation group was (3.45±0.44)scores, which was lower than (6.23±0.68)scores of the control group (P <0.05). The total effective rate of the observation group was 97.14%, which was higher than 80.00% of the control group (P <0.05). The incidence of complications in the observation group was 5.71%, which was lower than 28.57% in the control group (P <0.05). The scores of each dimension of quality of life in the observation group were higher than those in the control group (P <0.05). The satisfaction rate of the observation group was 97.14%, which was higher than 80.00% of the control group (P <0.05). Conclusion The effect of vertical double-pedicle breast reduction plastic surgery in the treatment of patients with macromastia is better, which can further improve the patient's breast sensation, shape and function, reduce the incidence of complications, and improve the quality of life and treatment satisfaction of patients. It is worthy of clinical application.