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Breast Reduction for Women

Excessively large and heavy breasts can undermine your confidence and cause health problems that affect your quality of life. Relief is possible at West End Plastic Surgery in Washington, D.C. through breast reduction surgery. Dr. Paul G. Ruff IV is a highly trained surgeon with significant experience in cosmetic breast surgery, including breast reduction.

Serving the Arlington and Reston areas in addition to Washington, D.C., Dr. Ruff invites you to request a consultation online to meet with him, or call his office at (202) 785-4187 to schedule a consultation.

Before & After Breast Reduction

Before photo
After photo

Before

After

For more photos of our patients, please view our photo gallery.

Why Breast Reduction?

In this surgical procedure, excess breast tissue, fat, and skin are removed from very large, heavy, or hanging breasts. Breast reduction surgery is generally performed to:

  • Make breasts smaller in order to reduce or eliminate various medical problems caused by heavy breasts
  • Balance the overall figure with a more proportioned breast size
  • Increase your confidence by enhancing your breast appearance

Learn More

Are You a Good Candidate for a Breast Reduction?

If you are in good general health with fully developed breasts and experience any of the following conditions, you may be a good candidate for breast reduction surgery:

  • Your heavy breasts cause medical problems such as neck and back pain, skin irritation or rashes, difficulty breathing at times, or changes in your bone structure
  • Your breast size limits your physical activity
  • Your overly large breasts make you feel self-conscious about your appearance
  • Your breasts are out of proportion with the rest of your body

Also keep in mind that you must not be breastfeeding or intend to breastfeed in the future in order to undergo breast reduction. For women who don't plan to have more children, breast reduction may be combined with a tummy tuck and other procedures as part of a Mommy Makeover.

Paul G. Ruff IV,
M.D. F.A.C.S.

Personalized, compassionate patient care is the foundation of West End Plastic Surgery's philosophy. Our board-certified surgeon, Dr. Paul G. Ruff IV embraces innovative techniques to ensure our patients get the best treatments available.

Meet Dr. Ruff Request a consultation

Meeting With Dr. Ruff

Prior to your surgery, you will have an initial consultation with Dr. Ruff IV and the staff of West End Plastic Surgery. At this consultation, your breasts will be evaluated and you will discuss your goals and expectations for the surgery. Dr. Ruff will discuss how large and which shape you would like your breasts to be, as well as the position of the nipple and areola.

Dr. Ruff and his staff will:

  • Review the various breast reduction options with you
  • Clearly discuss the potential risks of the procedure
  • Outline in detail how the surgery is performed and what you can expect before, during, and after the procedure
  • Provide detailed cost, payment, and insurance (if applicable) information
  • Answer all your questions

You will be asked to provide:

  • Details about your medical history
  • A list of all medications you currently take including over-the-counter medications such as aspirin, vitamins, and herbal supplements
  • Information regarding your tobacco and alcohol use

Before the surgery, you will need to have a mammogram performed and you may be asked to donate blood so that your own blood can be used during surgery if a transfusion is needed.

How the Procedure Is Performed

Your breast reduction procedure is performed in our state-of-the-art surgical suite or at one of the area hospitals where Dr. Ruff operates.

Dr. Ruff and his staff are dedicated to ensuring your complete comfort during and after the procedure, as well as your satisfaction with the outcome. The procedure generally takes 2 to 4 hours and is performed under general anesthesia.

Dr. Ruff makes incisions in the nipple-areola complex (the dark area around the nipple). The incisions extend below the nipples and occasionally into the fold under your breast. The doctor removes excess breast tissue, fat, and skin, contours a new breast shape, and repositions the nipple and areola. Stitches are used to close the incisions. Drains are frequently put in place to drain any blood or fluid that may collect in the surgical area. Taping and a surgical bra are placed over your breasts before you leave the operating suite.

What To Expect After Your Surgery

Activity When
Shower or Bath 1 to 2 Days After Surgery
Back to Work Few Days After Surgery
Driving Usually Within a Week After Surgery
Physical Contact With Breasts 3 to 4 Weeks After Surgery
Sexual Activity 1 Week After Surgery
Strenuous Activity 4 to 5 Weeks After Surgery
Fading of Scars Several Months to 1 Year

Before & After Photo Gallery

We're as thrilled with our patients' results as they are. Check out our before-and-after photo gallery and see for yourself the kind of work our talented surgeons do.

Immediately After Your Surgery

In most cases, you will be ready to go home shortly after the procedure. You will need to have someone drive you home after the surgery because you may be a bit sleepy after the anesthesia.

During surgery, your breasts will be covered with a gauze dressing, and a surgical bra will be placed over the dressings to help hold your newly contoured breasts in the correct position. A small tube called a drain may be inserted into each breast to help drain off excess fluid; you will be given instructions on how to care for the drains.

The First 24 to 48 Hours After Your Surgery

During the first 24 to 48 hours after your procedure, you will feel tired from the anesthesia and sore from the surgery. Dr. Ruff will prescribe pain medication to alleviate much of the discomfort. Your discomfort level will improve rapidly after the first 2 days.

You can take a shower or bath the day after your surgery; however, don't let the bandages covering your incisions get overly wet. You can take off the surgical bra placed over your breasts after the surgery during your shower or bath, but it must be worn at all other times (even while sleeping) for the first 2 weeks after your surgery.

The First 2 Weeks After Surgery

  • You will notice a marked improvement in your discomfort level during the first few weeks after your surgery.
  • The gauze dressings placed over your breasts during surgery will be removed 1 to 2 days after surgery.
  • Most of the stitches will dissolve; any non-dissolving stitches around the areola will be removed 5 to 7 days after surgery. Remaining stitches will be removed within 2 to 3 weeks.
  • Any bruising you experience will usually disappear in about 2 weeks.
  • Your stitches will be removed within 10 to 20 days after surgery.

You should sleep on your back for the first week after surgery to help keep your breasts in the correct position during initial healing. Placing pillows on either side of your body often helps ensure that you do not roll onto your side while sleeping.

During the first 2 weeks after surgery, you should also:

  • Wear the surgical bra placed over your breasts after surgery at all times, even while sleeping, to help hold your breasts in the correct position. You may take the elastic bra off to shower or bathe but must put it back on immediately after drying off. If the bra is too tight, call the staff at West End Plastic Surgery immediately — bras that are too tight can cause skin problems.
  • Avoid heavy lifting and straining for at least a month.
  • Use moisturizer several times a day if you have very dry skin after your procedure.

Resuming Your Normal Routine

Everyone heals at different rates, and you are the best judge of when you are ready for certain activities, but the following are general guidelines:

  • You can most likely return to work or school within a week after your procedure, unless your work is strenuous.
  • You can resume driving as soon as you experience no pain when you turn the steering wheel, usually within a week for cars with power steering and a little longer for manual steering.
  • Two weeks after surgery, you can begin to sleep without the special elastic bra you've been wearing. However, you should continue to wear this bra during the day for 4 to 6 weeks after your surgery.
  • When you begin to wear your own bras again, you will probably be more comfortable wearing a bra without underwire support until your incisions are fully healed.
  • You should not go without a bra, except while sleeping, for 4 to 6 weeks following your surgery. At your follow-up appointment, the doctor will let you know when you can begin to go without a bra.
  • Strenuous exercise can begin about 4 weeks after surgery. Our patients are encouraged to plan an exercise program and discuss it with the staff prior to resuming exercise.
  • The scars on your breasts should be protected from sunlight for at least a year after surgery.

Things to Be Aware of After Your Surgery

  • You may feel tired for several weeks after your surgery. Listen to your body, and rest when you need to.
  • You may see a small amount of fluid draining from your surgical incisions. Some crusting in the area is also normal. However, if you have bleeding that does not respond to 20 minutes of direct pressure or you have intense pain, call West End Plastic Surgery staff right away.
  • You will lose some feeling in your nipples and breast skin, caused by swelling after surgery. This usually fades within 6 to 8 weeks but can take up to a year.
  • Your breasts may heal at different rates. One breast may swell, one may feel less comfortable, or the shapes of your breasts may look different. This is normal, however, when your body is fully recovered, your breasts will look very similar and natural.
  • The skin of your breasts may appear shiny due to swelling. Within a few weeks, the swelling will disappear and the skin will return to a normal appearance.
  • You may experience random shooting pains in your breasts for a few months. These are a normal part of the healing process.
  • During your first menstrual period after surgery, your breasts may swell and hurt.

What Are Possible Side Effects or Risks?

As with any surgical procedure, there are risks associated with breast reduction. During your initial meeting with the doctor, these risks will be discussed and it will be determined whether you are a good candidate for breast reduction. As with any surgery, you can help reduce the risks of the procedure by closely following the instructions provided to you by Dr. Ruff and the staff of West End Plastic Surgery, who will be with you every step of the way to ensure that your procedure goes smoothly and that you have the outcome you desire.

Most likely risks include the following:

  • Loss of nipple-areola complex
  • Sensation changes
  • Scars
  • Uneven breasts
  • Breastfeeding limitations
  • Breast hardness

How Long Will the Results of Your Breast Reduction Last?

The results of your breast reduction are permanent. However, keep in mind that your breasts may change as a normal part of the aging process.

Questions You May Have

Are there other procedures that could be done along with breast reduction to enhance the size and shape of my breasts?

Liposuction is sometimes used around the breast and under the arms to remove excess fat in those areas during the breast reduction process.

Will my insurance coverage pay for my breast reduction?

Breast reduction may be covered by insurance because it corrects a physical condition that affects your general health. The staff at West End Plastic Surgery will work with you to obtain pre-authorization from your insurance company for your breast reduction procedure.

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West End Plastic Surgery 2440 M Street Northwest #200
Washington, District of Columbia 20037 (202) 785-4187 Monday–Friday: 8 a.m.–4:30 p.m. Get Directions
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