Evaluation and comparison of aesthetic results and patient satisfaction with bilateral breast reduction using the inferior pedicle and McKissock's vertical bipedicle dermal flap techniques

Ill the last two decades, McKissock's technique for reduction mammaplasty w as largely replaced by Robbins's inferior pedicle technique. However, a sub stantial number of plastic surgeons still perform McKissock's technique in the belief that it is superior to the inferior pedicle technique in tel ms of aesthetic results and complication rate. In this study, the authors comp ared the aesthetic results, complication rates, and patient satisfaction wi th the two techniques. Numerous studies in the past few years have shown an improvement in physica l symptoms In addition to excellent patient satisfaction after breast reduc tion. However, almost all of these studies have used questionnaires that we re mailed to the patients for evaluation. In the present study, aesthetic e valuations by the surgeon and an objective observer were performed in addit ion to evaluations by the patients themselves, thereby increasing the objec tivity and the significance of the patients' evaluations. Two groups of 24 and 27 patients were compared. The groups were almost identical in terms of demographic data and the amount of breast tissue removed. The aesthetic re sults were good to excellent in both groups, and the groups had similar com plication rates. When the patients' evaluations were compared with those of the surgeon and the objective observer, no significant difference was foun d between the observer and the patients. In one of the groups, the surgeon' s evaluations were significantly higher than those of the patients, althoug h they were not significantly higher than the observer's. In terms of aesth etic results, complication rates, and patient satisfaction, no differences existed between the groups. In addition, the patients' evaluations were det ermined to be a reliable index of aesthetic results and, in these cases, th ey were often identical to objective evaluations.