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Breast Reduction

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

Large, pendulous breasts can be burdensome and make it difficult to complete even the simplest of tasks. 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 rock a strapless dress without worry.

Our office is located in Bethesda and our Maryland Board Certified plastic surgeons Dr. Franklin Richards, M.D., Dr. Dean Jabs, M.D., and Dr. Keshav Magge, M.D. have more 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 DC and 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 (macromastia) which 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. The breasts are also lifted, 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 plastic surgery procedures performed.

Real Patient Results


Ideal Candidates

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 symptomatic 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 finding a properly fitting sports bra. And rashes tend to develop under the breast fold from the 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 aesthetic desire. And you will not only look good, but feel good too.

Methods Used

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; this 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 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.


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 border 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 elevation.


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 at our Bethesda, MD you will explain the physical and/or emotional strain macromastia is causing you. He will perform a thorough examination, and both you and him will determine the best method for optimal results. You surgeon will go over pre-operative instructions, post-operative instructions, and write prescriptions for medication you will require before and after your procedure. He will also explain the 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 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.


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

  • Possibly, a preoperative mammogram is necessary for breast reduction patients in addition to other assigned evaluations and test depending on your age and medical history.
  • Please stop smoking and taking 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. It is best for someone to stay overnight with you.
  • Pick up any medications your surgeon prescriptions 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.
  • On the day of your surgery, please wear a loose fitting top that you do not need to pull over your head.

Procedure 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 ancillary or additional procedures. When you arrive, your surgeon will mark the incision locations while you are in an elevated position 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 performed as well to lift the newly contoured breast to a more youthful, proportionate position.

Ancillary Procedures

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

Breast Lift

Generally, breast lifts are performed along with breast reduction 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 which 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.

Patient Reviews

Literally the best practice ever. I chose Dr. Richards based on his reviews and him and his team did not disappoint: Joanne is amazing and will answer all your questions and make you feel comfortable and Tiffany is such a knowledgeable, sweet Nurse. She is so helpful with questions too, literally any time of day! I would give this practice more stars if I could, such a great team!

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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; 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; 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 you are fully recovered, women 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.


Average cost: $6,000-$8,000

The cost of your breast reduction procedure will depend on your specific case and if you opt to receive additional treatments or procedures. 

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 while determining 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!

Board Certified Plastic Surgeon at | + posts

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