Word of the Wise: A Propensity-Matched Comparative Analysis of Breast Reduction Incision Patterns on Clinical Outcomes and Quality of Life

Introduction: Breast reduction surgery addresses both functional complaints and aesthetic concerns. Two commonly used incision patterns in the US are the Wise and vertical patterns, but there are limited data comparing their clinical and quality of life (QoL) outcomes. This study evaluates and compares these outcomes between the two techniques.

Methods: A retrospective review from 2016 to 2022 examined subjects who underwent breast reduction with either vertical or Wise incision patterns. A propensity-scored match was performed based on age, body mass index (BMI), ptosis grade, and breast tissue removal. Surgical and patient-reported outcomes (BREAST-Q) were analysed.

Results: Out of 379 patients, a total of 92 breasts (46 patients) were identified after propensity-score matching, with a mean age of 30.4 years and BMI of 26.5 kg/m². Vertical incisions were more likely to have the superomedial pedicle utilized and a larger nipple diameter. There was no significant difference in ptosis grade and tissue removal. There were no differences in clinical outcomes, aesthetic outcomes, reoperations, readmissions, or emergency room visits (p > 0.05). QoL analysis identified a significant improvement within both cohorts across domains: satisfaction with breast, psychosocial well-being, and physical well-being (p < 0.001). However, patients with the Wise pattern technique demonstrated a significant improvement in sexual well-being (p = 0.002).

Conclusion: Both the vertical and Wise incision patterns are safe and provide significant QoL improvements. While both techniques improve multiple QoL domains, the Wise pattern offers additional benefits in sexual well-being. These findings can guide surgeons in discussing outcomes with patients.

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