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Breast Reduction

Conveniently located to serve the areas of Maryland, Virginia and Washington, D.C.

Large breasts can be burdensome and make it difficult to complete simple tasks or certain activities. They can be painful and affect your posture from the constant strain. Breast reduction is a plastic surgery procedure that reduces the size and volume of your breasts to make them more proportionate to your body. This procedure provides both alleviation of physical strain as well as an increase in self-confidence when women are finally able to wear the clothing they want to without worry.

Our office is located in Bethesda and our Maryland board-certified plastic surgeons Dr. Franklin Richards, Dr. Dean Jabs, and Dr. Keshav Magge have over 50 years combined medical experience. Patients come from all over the country to have procedures performed by our surgeons. Our office is very close to Washington, D.C. and is right across the border of Virginia.

What is Breast Reduction?

This procedure removes fat, glandular tissue, and skin from the breasts making them smaller, lighter, and firmer.

Breast reduction, or reduction mammoplasty, is a procedure performed on women with large breasts (a condition medically known as macromastia) that may be causing a variety of medical problems such as back and neck pain, skin irritation under the breasts, and bra strap grooving on the shoulders.

During breast reductions, the breasts are lifted, excess tissue and skin are removed, and the areola can be reduced in diameter to make them more proportionate. Very often this can be done using a minimal incision technique that eliminates the long scar under the breast. Breast reduction surgery delivers one of the highest patient satisfaction rates of all breast surgery procedures.


Real Patient Results


Ideal Candidates For Breast Reduction

Ideal candidates for breast reduction surgery are women who are in good health but struggle with symptomatic macromastia or emotional distress caused by their large breasts. Women who suffer from negative symptoms due to macromastia experience physical aches and pains due to their large breasts. Macromastia most typically causes back, neck, and shoulder pain, poor posture, and permanent indentation in the shoulders due to the heavy strain on bra straps.

Exercising can be a hard feat for women with macromastia as their breasts tend to “get in the way,” let alone the difficulty in finding a properly fitting sports bra. And rashes tend to develop under the breast fold from constant skin rubbing.

Sometimes, women may have one breast that’s larger than the other and seek breast reduction for aesthetic symmetry. While for others, macromastia causes emotional distress from social discomfort and unwanted attention. No matter if physical, mental, or aesthetic reasonings, a breast reduction at Cosmetic Surgery associates will decrease the size of your breasts to your desired aesthetic appearance. Not only will you look good, you’ll feel good too.

Methods Used During Breast Reduction Procedures

There are two incision techniques that our surgeons use at Cosmetic Surgery Associates: the vertical incision and the anchor incision. The one chosen for your surgery will depend on the extent of your individual case, which will be determined during your private consultation.

All breast reduction procedures are based on a pedicle. This means the blood supply to the nipples remains intact during the procedure while the appropriate amount of surrounding breast tissue and skin are removed to achieve desired reduction. This also helps to protect the functionality and sensation of the nipples. There are two pedicle methods: inferior and superior. This too will be decided during your consultation. The areola can be reduced in size during your breast reduction to make it aesthetically proportionate to your new breast size.

Vertical (Lollipop) Incision

Mimicking the shape of a lollipop, the vertical incision method uses 2 incisions. One is made around the border of the areola, while the other runs from the base of the areola down to the bottom of the breast. The appropriate amount of breast skin and tissue is removed to reach the desired size, and the incisions are then closed. The breast becomes slightly lifted from this procedure, giving you a proportionate-sized bust at a youthful height.

Anchor Incision

Making the shape of an anchor, this method uses 3 incisions to achieve great reduction. One incision is made around the areola border, the second runs vertically down from the areola base to the breast crease, and the third is made along the breast crease. The anchor lift is reserved for those who require a severe reduction in size or have lost a significant amount of weight.


During your private consultation with one of our accredited surgeons in Bethesda, MD, you will describe the physical and/or emotional strain macromastia is causing you. Our surgeons will perform a thorough examination, and both you and your doctor will determine the best method for optimal results.

Your surgeon will go over pre-operative instructions, post-operative instructions, and write prescriptions for the necessary medications you will need both before and after your procedure. They will also explain the healing process from start to the end of your recovery period. Please feel free to ask questions at this time, it is important that you are aware of all aspects of the procedure and are fully comfortable with your decision.

The world-renowned surgeons at Cosmetic Surgery Associates are highly trained in breast procedures and their combined years of experience means you can achieve excellent results that fulfill your aesthetic desires.

Preparation for Breast Reduction

Each patient will receive personalized preparation instructions, but below are general instructions all patients should follow.

  • In some cases, a preoperative mammogram is necessary for breast reduction patients in addition to other assigned evaluations and tests depending on your age and medical history.
  • Please stop smoking and any anti-inflammatory medications 2 weeks prior to your procedure.
  • Arrange for a friend or family member to drive you home as you will not be able to drive following a breast reduction procedure. It is best for someone to stay overnight with you.
  • Pick up any medications your surgeon prescribes you so you have them readily available when needed.
  • Have any necessary recovery items at counter level since your range of arm motion will be limited for several weeks.
  • On the day of your surgery, please wear a loose fitting top that you do not need to pull over your head to remove.

Breast Reduction Process

Breast reductions are performed on an outpatient basis under general anesthesia. The procedure usually takes three hours depending on the extent of surgery needed and whether you opt to undergo additional procedures.

When you arrive, your surgeon will mark the incision locations while you are sitting up as your breast shape will change when you lay on the operating table. This step is important in delivering your specific aesthetic goals. Once anesthetized, your surgeon will make the incisions, remove the appropriate amount of breast skin, fat, and tissue, and the incisions will be closed with sutures. A breast lift is often performed as well to lift the newly contoured breast to a more youthful, proportionate position.

Complementary Procedures

Breast reduction can be performed on its own or in conjunction with ancillary procedures for more comprehensively enhanced results. This can include additional breast procedures, body contouring procedures, or even facial procedures to rejuvenate your look even more.

Breast Lift

Generally, breast lifts are performed along with breast reductions to improve the size, shape, and elevation of the breasts. The same incision can be used to accomplish the lift, removing the extra amount of skin needed for sufficient lift.


Liposuction is a body contouring procedure that uses suction to remove fat from various parts of the body. It is one of the most popular plastic surgery procedures in the United States, with the number of liposuction patients continually rising. It can be performed on the:

  • Arms
  • Chin
  • Chest
  • Back
  • Abdomen
  • Waist
  • Hips
  • Thighs
  • Buttocks

Breast reduction combined with liposuction is considered a mommy makeover procedure. Mommy makeovers combine breast and abdominal cosmetic procedures to enhance the bodies of women who have given birth. Depending on how much fat is removed, you may require a tummy tuck to tighten any loose skin.

Tummy Tuck

A tummy tuck is a procedure that removes excess abdominal skin and tightens the abdominal muscles to create a flat, slim midsection. It can be performed at the same time as breast reduction, another mommy makeover option. Liposuction can also enhance the results of a tummy tuck, creating a smaller, defined midsection.


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Recovery varies between patients, but your surgeon will give you a personalized recovery plan to optimize your results.

Typically after your surgery, you will be placed in a support bra to wear for several weeks to help the breasts form to their new, smaller contour.

It is normal for your breasts to feel tender and sensitive, and your nipples may feel slightly numb following your breast reduction. These sensations should subside on their own. Pain medication can be prescribed to help alleviate discomfort. Although you may not feel up to it, walking is important to prevent blood clots.

You will not be able to shower for 2 days, but sponge baths are okay. When sleeping, keep your head and back elevated. You will most likely return to work and social activities in about two weeks. Do not partake in strenuous activity for at least 3-4 weeks to ensure proper healing. Rest is the key to a full, successful recovery.

After they are fully recovered, breast lift patients often experience a great increase in self-esteem and self-confidence when they find that their clothes fit much better and they are able to exercise worry free and pain free.


Click to download the information provided on our website in a PDF format.


Can breast grow back after reduction?

Its possible for breasts to grow in size after a breast reduction because of factors like hormones, genetics, pregnancy, and weight gain.

Can you drink alcohol after breast reduction?

Your plastic surgeon can give you the best idea of when you can drink alcohol after your recovery period. Generally, you should plan to abstain from alcohol for at least one week.

Do you lose feeling in your nipples after breast reduction?

Its normal to temporarily lose some feeling in your nipples after breast reduction, especially with certain incision patterns. If this is a concern, make sure to discuss your preferences with your plastic surgeon during your consultation.

Do you lose weight after breast reduction?

You may lose a negligible amount of weight with breast reduction, especially if your breasts are very large for your body. However, breast reduction should not be considered a weight loss procedure.

How can I reduce my cup size?

A breast reduction can reduce bra size, but it can be difficult to achieve a specific cup size with surgery. Your plastic surgeon can give you the best idea of what to expect afterward.

How dangerous is breast reduction surgery?

There are risks that come with every surgery, but you can mitigate them by selecting a board-certified plastic surgeon.

How do breast reductions work?

Breast reduction works by removing breast tissue and fat from the breasts with surgical techniques. Its best for women who suffer from symptoms of large breasts like back pain, chafing, or difficulty moving.

How do I know if I need a breast reduction?

If you regularly experience pain and discomfort from your breasts, as well as difficulty being active and mobile, you may benefit greatly from a breast reduction procedure.

How long does it take for swelling to go down after breast reduction?

It can take 1-2 weeks for most swelling to subside after surgery. You may have residual swelling that takes longer to go away as well.

How long does it take to recover from a breast reduction?

You should plan to take 1-2 weeks away from work or school after your procedure. After this period, most patients are able to return to their regular schedules.

How many cup sizes can you go down with breast reduction?

Its difficult to measure cup sizes when it comes to breast surgery, but most patients go down one cup size.

What causes breast reduction?

Most women opt for breast reduction because of symptoms like back pain, chafing and rash, difficulty being active, and negative attention for their breast size. Because of these symptoms, breast reduction comes with one of the highest satisfaction ratings of any plastic surgery procedure.

What happens after breast reduction?

After breast reduction, its important to rest and recover for 1-2 weeks to allow your incisions to heal. You can expect swelling and discomfort during this time, and youll be given detailed instructions to follow to ensure a successful recovery.

When can I sleep without a bra after breast reduction?

Its important to wear a compression bra as much as possible after breast surgery to support your breasts and reduce swelling. Your plastic surgeon will indicate when you can begin sleeping without it (generally after 6 weeks).

When can I wear a normal bra after breast reduction?

Underwire bras can irritate your incisions after breast surgery, so its important to avoid wearing them until your incisions are fully healed. Most patients can return to wearing regular bras around 6 weeks after surgery.

Does breast size affect weight?

This can be different for each woman - generally, smaller-framed women may notice a bigger impact on their weight after breast reduction. This procedure should not be considered a weight loss option.

Does insurance pay for breast reduction?

Breast reduction can sometimes be considered a medical necessity if you suffer from symptoms like back pain, skin rash, or difficulty being active. We encourage each patient to discuss their coverage with their provider prior to consultation.

Does weight gain increase breast size?

This can be different for each woman, but breast size generally increases and decreases with weight gain and loss.

Has anyone had a second breast reduction?

Many women return for a second breast reduction, especially if they become pregnant or experience weight fluctuations after their first procedure.

How is the recovery from breast reduction?

You can expect some pain and swelling after your breast reduction, but youll be given detailed instructions to follow in order to manage it.

How long do stitches stay in after breast reduction?

This can depend on your plastic surgeon and their preferred techniques, but stitches can generally be removed within one week of surgery.

How long does it take breast reduction to heal?

It can take 1-2 weeks for your incisions to heal, with additional time to make a full recovery. Youll be given a detailed timeline of what to expect during your consultation.

How much is 500 grams breast reduction?

A measurement in grams usually refers to the amount of tissue removed per side. 500 grams roughly equates to 2.5 cup sizes (although the bra size you wear may not directly correlate to the amount removed).

How painful is a breast reduction?

Breast reduction comes with some pain and discomfort, but youll be prescribed medications to help manage it. This can help you get the rest you need for your recovery.

Is it OK to wear a sports bra after breast reduction?

Yes - You should plan to wear a supportive sports bra or surgical compression bra after your procedure to support your new breasts. Wear this as much as possible, according to your plastic surgeons instructions.

Is it worth getting a breast reduction?

Many patients report a very high rate of satisfaction after breast reduction due to reduced symptoms that interfere with everyday living. This makes it one of the most sought-after procedures.

Why do breasts grow back after a reduction?

There are many reasons for this that can be unique to each patient - some are genetically predisposed, while others experience weight or hormonal fluctuations that change the breasts.

Why do my breasts hurt and feel heavy?

Large breasts can cause discomfort and difficulties being mobile in some women. This makes breast reduction a popular and effective option.

Scheduling Your Breast Reduction Consultation

If you have been thinking about breast reduction surgery we recommend reaching out to our office to set up a consultation with one of our Maryland board-certified plastic surgeons. Our office is just 20 minutes from Chevy Chase and 10 minutes from Rockville and Potomac. During this consultation, the surgeons will go over the procedure in detail, answer all of your questions, and determine if you are a good candidate and if this procedure is the best option to meet your cosmetic goals. Please feel free to schedule a private consultation today!

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Our Plastic Surgery Associates team includes Dr. Franklin Richards, Dr. A. Dean Jabs, and Dr. Keshav Magge. Each of our plastic surgeons is board-certified, and together they have over 60 years of combined experience. Drs. Richards, Jabs, and Magge are all highly qualified in procedures for the face, breast, and body, and pride themselves in providing excellent results through our state-of-the-art, Quad A certified operating centers