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Robbins vs. McKissock: Does the Surgical Technique Change Your Result for Breast Reduction?

The Search for the “Perfect” Technique

When you research breast reduction, you will find several different surgical methods. For decades, surgeons have debated which technique is superior.

Two of the most famous methods are the Inferior Pedicle (Robbins technique) and the Vertical Bipedicle (McKissock technique). Many surgeons prefer one over the other. They often believe their chosen method provides better shapes or fewer complications.

But does the specific technique actually change your final look? A study from the Rambam Medical Center in Israel compared these two approaches to find out.

The Study: A Three-Way Evaluation

Researchers compared two groups of patients. One group had the McKissock technique. The other had the Inferior Pedicle technique.

To get the most accurate results, they used three different perspectives:

  1. The Patients: How happy were they with their results?
  2. The Surgeon: How did the doctor rate the aesthetic outcome?
  3. An Objective Observer: How did a neutral third party rate the breasts?

The Findings: A Statistical Draw

The results were clear: Both techniques are excellent.

  • Aesthetics: The researchers found no significant difference in the final aesthetic results. Both groups achieved “good to excellent” outcomes.
  • Safety: The complication rates were nearly identical for both methods.
  • Satisfaction: Patients in both groups reported high levels of satisfaction. Interestingly, the patients’ own evaluations were very similar to the objective observer’s ratings.

Expert Critique: Why Technique Isn’t Everything

In the accompanying discussion, Dr. Robert Ruberg noted that these results are predictable. He explains that if two techniques use the same Wise Pattern (the “Anchor” scar) for the skin, the final look is usually the same.

However, Dr. Ruberg pointed out several “glaring deficiencies” in the study that patients should keep in mind:

  • Different Surgeons: A single senior surgeon performed the McKissock cases. Meanwhile, various residents performed the Inferior Pedicle cases.
  • Different Hospitals: The surgeries took place in very different settings (one private and one public hospital).
  • Patient Motivation: The two groups of patients had different socioeconomic backgrounds and different motivations for seeking surgery.

The Takeaway for You

This research proves that there is no “best” technique for every patient. The skill and experience of your surgeon matter more than the name of the method they use.

As Dr. Ruberg suggests, no study has ever clearly demonstrated that one technique is superior to all others. Instead, multiple techniques are highly effective at relieving your symptoms and improving your health.

Your Next Step:

Do not choose a surgeon based on a specific “named” technique. Instead, choose a board-certified plastic surgeon whose “Before and After” gallery reflects the results you want.

Ask yourself “Who is the Best Plastic Surgeon Near Me?”.
Contact us to know if you are a suitable candidate for Breast Reduction.

Revera Clinic caters with the Best Plastic Surgeon in Hyderabad!


References

Written by revera-admin

Avoiding the “Bull’s-Eye”: How to Get a Natural Nipple Scar

The Problem: The “Target” Effect

Breast reduction surgery creates a new shape for your breast. However, it also creates a scar around the nipple.

Traditionally, surgeons cut the nipple in a perfect oval shape. When this heals, it can leave a conspicuous white line. This pale scar contrasts sharply against the darker skin of the areola.

The result is often called a “bull’s-eye” or “target-like” appearance. The nipple looks “stuck on” rather than naturally blending with the breast skin.

The Solution: A Ragged Edge

A technique from the Queen Victoria Hospital in the United Kingdom offers a clever refinement to solve this aesthetic problem.

Instead of a perfectly smooth cut, the surgeons use a jagged, shelving incision.

How It Works

  1. The Cut: The surgeon makes a “ragged” incision all around the nipple edge, rather than a straight line.
  2. The Slope: They angle the cut toward the center to create a sloping shelf.
  3. The Fit: This allows the nipple to sit better in its new location. The jagged edges break up the scar line.

This mimics nature. On an unoperated breast, the pigmented nipple skin merges gradually with the surrounding skin. This technique restores that natural, graduated look.

The Results: High Satisfaction

The surgeons tested this refinement on 15 patients undergoing bilateral breast reduction. They monitored the healing carefully.

  • Safety: There were zero complications. No patient experienced infection or delayed healing.
  • Satisfaction: The aesthetic results were excellent. 90.9% of patients (10 out of 11 fully reviewed) expressed satisfaction with the final shape of their nipple.

Conclusion

You do not have to settle for a “bull’s-eye” scar. Small refinements in surgical technique can make a big difference.

By using a jagged incision, your surgeon can break up the visual line of the scar. This helps the nipple blend naturally with the breast, avoiding the artificial “target” look.


Reference

[1] Pandya, A. N. M.S., M.Ch., F.R.C.S.; Arnstein, P. M. F.R.C.S. “Refinement of Nipple Areolar Placement in Breast Surgery.Plastic and Reconstructive Surgery 101(3):p 806-807, March 1998.

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The Great Trade-Off: Better Scars or Fewer Revisions?

Vertical vs. Anchor: Which Should You Choose?

When you choose a breast reduction technique, you often have to decide between two priorities. Do you want the smallest possible scar? Or do you want to avoid a second “touch-up” surgery later?

A classic prospective study from the University of Puerto Rico highlights this exact trade-off. It compared the two most common breast reduction methods: the Vertical (“Lollipop”) pattern and the Wise (“Anchor”) pattern.

The Study: A Fair Comparison

To get a clear answer, researchers designed a randomized study. This removes bias. They followed 208 women undergoing moderate breast reductions (removing about 500g of tissue per breast).

  • Group 1: 105 women had the Wise Pattern (Anchor scar).
  • Group 2: 103 women had the Vertical Pattern (Lollipop scar).

Crucially, the same plastic surgeon performed all the surgeries to ensure consistency.

The Results: Vertical Wins on Looks

Six months after surgery, the patients rated their satisfaction. The results were clear regarding aesthetics.

  • Better Scars: Patients in the Vertical group were significantly happier with their scars compared to the Anchor group.
  • Better Shape: Vertical patients gave their “overall aesthetic results” a score of 8 out of 10, compared to just 6 out of 10 for the Anchor group.

If your main goal is a prettier breast with less visible scarring, the Vertical technique is the clear winner.

The Catch: The “Dog-Ear” Problem

However, the Vertical technique had a downside.

Because the Vertical technique does not have a horizontal incision under the breast, it sometimes leaves a small fold of excess skin at the bottom. Surgeons call this a “dog-ear.”

  • Vertical Group: 11% of patients needed a minor surgical revision to fix these dog-ears.
  • Anchor Group: 0% of patients needed a revision.

What This Means for You

This study reveals a fundamental choice for patients with moderate-sized breasts.

Choose the Vertical (Lollipop) Pattern if:

  • You prioritize having minimal scarring.
  • You want the best possible aesthetic shape.
  • You are willing to accept a small risk (11%) of needing a minor “touch-up” procedure later to trim extra skin.

Choose the Wise (Anchor) Pattern if:

  • You want “one and done” surgery with almost zero risk of revision.
  • You do not mind having a longer scar that runs underneath the breast fold.

Talk to your surgeon about what matters most to you: the absolute best scar, or the absolute lowest maintenance.


Reference

[1] Cruz-Korchin, Norma M.D.; Korchin, Leo D.D.S., M.S. “Vertical versus Wise Pattern Breast Reduction: Patient Satisfaction, Revision Rates, and Complications.” Plastic and Reconstructive Surgery 112(6):p 1573-1578, November 2003.