Purpose: Bilateral breast reduction (BBR) surgeries have positive psychological and physical effects for women. New Zealand has a lower number of plastic surgeons per capita than comparable countries, with 9 fully qualified plastic surgeons catering for the Waikato population of 496,700 people (1). We did a retrospective service review of BBR procedures performed at Waikato Hospital Plastics Surgery Department to determine if the service can be improved to help improve accessibility. Methodology: Data for all patients who had BBR performed from 1st July 2017 to 31st July 2023 were extracted and analyzed using CostPro software. Results: There were 141 BBR procedures performed over 7 years. The peak was in 2018 (39 cases) and only 10 cases were performed in 2023. Cases were performed at Waikato Hospital (n=98, 69.50%), Thames Hospital (n=11, 7.8%) and the remaining were outsourced to private. BBR was performed in 135 females (95.74%) and 6 males (4.26%).95 cases (67.37%) were referred by GP,19 cases (13.47%) from other specialities within the same DHB, 23 cases (16.31%) from other DHBs, and 4 cases from private. The mean waiting time for surgery was 23.2 months in 2023, but only 7.7 months in 2017. The average length of stay after BBR was 1.31 days (range 1-1.42 days) over 7 years. Conclusion: This study has shown a reduction in the number and longer waiting time of BBR procedures performed over the past 7 years. Although the length of stay may vary for individual patients depending on factors such as case complexity and postoperative complications, the average length of stay remains similar. References:(1) Adams BM, Klaassen MF, Tan ST. The future of the New Zealand plastic surgery workforce. N Z Med J. 2013 Apr 5;126(1372):37-46. PMID: 23793176.