It is common for women with overly large, pendulous breasts to experience both emotional and physical discomfort as a result of their enlarged breasts. Women who are self-conscious or embarrassed about their large breasts tend to avoid standing up straight or wearing certain types of clothes.

Women with overly enlarged breasts often suffer from chronic physical discomfort. Their bra straps constantly dig into their shoulders, creating grooves, or indents, in their skin. Large-breasted women may also experience chronic neck and back pain, due to the weight of their breasts constantly pulling them forward and causing them to hunch over inadvertently. They may also frequently get rashes under their breasts. Finally, engaging in certain physical activities such as running or jumping can be painful with overly large breasts.

Before and After Photos

What is a Breast Reduction?

This cosmetic procedure will improve the appearance of your chest and reduce discomfort.

A breast reduction is a surgery that reduces excess tissue in either one or both breasts. This surgery can be used to correct asymmetry and will ultimately make the breasts smaller in size. Large breasts can be uncomfortable and cause physical pain. Plastic surgery treatments like breast reduction techniques can reduce discomfort and help you regain a feminine physique.

Breast Reduction Benefits

Maryland plastic surgeon Joseph Michaels, MD, FACS, offers breast reduction surgery to help alleviate the pain, discomfort and embarrassment associated with having extremely large breasts.

The aesthetic goal of breast reduction surgery is not to reduce the size of your breasts so drastically that you no longer look like yourself, but to give you smaller breasts that are perkier, shapely and in balance with the rest of your body. The most common comment that Dr. Michaels’ breast reduction patients make after surgery is, “I can’t believe I didn’t do this sooner!”

Undergoing surgical breast reduction in Rockville or Fairfax with Dr. Michaels provides relief from neck, back and shoulder pain — almost immediately after surgery.

Incision Pattern Options

Many of Dr. Michaels’ patients are concerned with the location and degree of scarring that they may have following their procedure. Traditionally, patients were left with significant incisions that surrounded the areola (the darker-skinned area around the nipple), a vertical incision that extended from the base of the areola to the natural fold of the breast and an incision that extended the full length of the natural fold of the breast. There are newer techniques that can limit the length of the incisions needed to obtain the desired size and shape of your breasts.

During your consultation, Dr. Michaels will evaluate your breast anatomy and discuss your aesthetic concerns. Based on this information, he will design a treatment protocol that best suits your individual needs.

Based on the degree of glandular breast tissue to be reduced, the amount of excess skin present and the distance that the nipple-areolar complex needs to be elevated, Dr. Michaels will determine which technique and incision pattern he will utilize during your procedure.

Anchor Incision

For patients requiring a significant breast reduction and elevation of nipple-areolar complex, the traditional breast reduction approach is still commonly utilized. Again, this procedure involves the use of a horizontal inframammary incision positioned underneath the breast’s natural crease, a vertical incision that extends down the front surface of the breast and a periareolar incision that runs along the outside edge of the areola. These incisions are sometimes referred to as the “anchor” pattern.

Lollipop Incision

Incisions will be made thoughtfully and discreetly.

Patients that require smaller reductions and minimal elevation of the nipple-areolar complex may be suitable candidates for a modified “short-scar,” or vertical, breast reduction approach. This procedure involves reducing the breast size through a periareolar and vertical incision only. These incisions are sometimes referred to as a “lollipop” pattern.

One incision pattern or a combination may be used to treat your breasts. The incisions will be gone over in your personal consultation and a method will be developed.


This surgery is ideal for women with overly large, uncomfortable breasts. If you find that it is hard to fit into bras and that physical activities often result in breast pain, it may be time to consider a breast reduction. If you are interested in what a breast reduction can accomplish for your life, reach out to our office today to learn more.

Personal Consultation

Your health and safety are of the utmost importance to us.

In your private meeting with Dr. Michaels, you will have the opportunity to express your concerns and share how you would like your chest to appear. Photos of breast reduction surgery before and after female rejuvenation will help you gain a realistic expectation of what will be accomplished. You will be listened to and your health will be inquired about. Questions about your past procedures, current health, allergies, and lifestyle will be asked. An examination of your breasts will take place and from all of this information, Dr. Michaels will determine if a breast reduction surgery is your ideal solution. He may suggest a breast lift to include in your reduction surgery to bring about your best results.

Together, we will create a treatment plan that transforms your chest and alleviates discomfort.


Prior to your surgery date, you will want to arrange for rides to and from the appointment. Ask a friend or family member to stay with you for the first twenty-four hours of recovery. It will help to have someone around to assist you and help you adjust. Pick up prescribed medications and stop smoking. Smoking habits will need to be paused for a few weeks before and after surgery. Twelve hours before surgery you will need to stop eating and drinking. Get a good nights rest and wear comfy, loose-fitting clothes to the appointment.


It is common for women to undergo breast lift at the same time as breast reduction surgery.

Typically, the breast reduction procedure is performed as an outpatient surgery. The procedure is done under general anesthesia to ensure the patient is comfortable for the entire duration of surgery.

After Dr. Michaels makes the incisions, he eliminates the extra skin, fat and glandular tissue from the breast. Most of the skin and tissue is removed from the lower part of the breast. This helps preserve the tissue in the upper part of the breast that contributes to breast cleavage. Dr. Michaels will also move the nipple to a more elevated and centralized position on the breast, taking care to keep the nipple attached to the underlying tissue to maximize the chance of preserving nipple sensation.

It is common for women with extremely large breasts to also have overly enlarged areolas. To decrease the size of the areola so that it is in proportion to the smaller size and shape of the breast, the Maryland breast surgeon excises some of the pigmented skin from the outer circumference of the areola.

Once Dr. Michaels is satisfied with the new size and shape of the breast, he closes the incisions with dissolvable sutures and then dresses the breasts with bandages and an overlying surgical bra.

Quick Facts


2-4 hours





Side effects

Temporary swelling, muscle tightness, bruising and some pain


Pain, bleeding, infection, asymmetry, damage to nerves (in rare cases), need for revision


4-7 days: back at work. 1 week: light exercise only. 2-3 weeks: more strenuous activity allowed. 8-12 weeks: swelling resolves and patient can resume normal activity.

Duration of results

Variable, as further sagging occurs with age


Following the surgery, your chest will be sensitive and swollen. Pain medication will help control discomfort and we encourage you to take brief walks. Low impact exercise like walking will improve your circulation and help you recover well. Breast reduction surgery recovery time will vary between each patient as everyone has a unique body and healing process. Be sure to get plenty of rest and drink lots of water. A follow-up appointment with Dr. Michaels will allow our staff to ensure you are healthy and your results are coming in well. Most patients can return to work after a week and exercise after a few weeks.


You will already have noticed an improvement in the appearance of your chest following treatment. Your results will only get better throughout your recovery process. A breast reduction will promote long-lasting results. This outcome should set in about eight to twelve weeks after surgery. It is important to keep a healthy, consistent weight. An active life and healthy eating will help you keep your results for a long time! If you’re thinking, “I want breast reduction surgery” then today is your day! Reach out to us to schedule a consultation with our accredited, caring staff today.

Breast Reduction Surgery Cost

Breast reduction surgeries are customized to your anatomic features and body goals. The personalized nature of these procedures requires costs to fluctuate between patients. A cost breakdown will be gone over in your personal consultation. If you are not near our offices in Maryland, Virginia and Washington, D.C. we suggest you call our office to learn the estimates of these surgeries or search, “Breast reduction surgery near me”. Do your research and make sure to find a credible surgeon. We are more than happy to help patients from all over and agree that a trip to our office is well worth it. If you would like to learn more about breast reduction, call (301) 468-5991 in Rockville, Maryland or (703) 957-8610 in Fairfax, Virginia to schedule a consultation.


How painful is breast reduction surgery?

Breast reduction surgery is not considered a painful surgery. You will be under anesthetic at the time of surgery and pain medication will keep you comfortable afterward. You will experience swelling and bruising after the surgery but these symptoms will fade after a week or two.

How dangerous is breast reduction surgery?

Breast reduction surgery comes with the same risks as any surgical procedure. The surgery will not be pursued if you have a pre-existing health condition that will deter your body from healing properly. A personal consultation will be required so our surgical team can get to know you, learn about your health background, and determine which techniques should be used to improve your appearance. If breast reduction surgery is deemed as a good solution for you, it will be planned out. It will ultimately be up to you whether or not to go forward with the surgery. We take our patient’s health and safety seriously and want to make sure you are comfortable with the different aspects of this procedure.

What happens during a breast reduction?

In a breast reduction surgery, general anesthesia is administered to help you relax and have a comfortable surgery. Incisions will be made along each breast in a predetermined fashion. Excess tissue and skin will be reduced and the incisions will be closed. Bandages will be applied and you will be taken to a recovery room.

How long is a breast reduction surgery?

A breast reduction surgery takes about two to four hours.

What to expect after breast reduction surgery?

After surgery, your chest will be swollen, sore, and bruised. Any discomfort can be controlled with pain medication. You will need to take about a week away from work to rest and recoup. A follow-up appointment will allow Dr. Michaels to monitor your health and breasts. In this appointment, he will inform you of what to expect for the rest of your recovery and when to return to normal activities.

If you would like to learn more about breast reduction, click here or call (301) 468-5991 in Rockville, Maryland or (703) 957-8610 in Fairfax, Virginia to schedule a consultation.