For patients, the obvious difference between the varying breast reduction technique is the extent and position of the scar. A breast reduction addresses two separate, but inter-linked problems: excess skin and excess breast tissues. The pattern of scars placed on the breast is a consequence of the technique used to remove the excess skin.
For a woman with a breast composed of a large amount of breast skin surface area, it often necessary to use a Wise pattern, or 'anchor' scar to reduce the skin 'acreage' of the breast in both the horizontal and vertical dimension. This scar runs around the nipple-areolar complex (NAC), down the front of the breast and runs along the breast fold for a variable distance.
Some women with more compact, dense breasts, without a huge amount of skin excess do very well with a vertical pattern, resulting in a 'lollipop' scar, which has no scar beneath the breast.
The amount of breast tissue removed, and the pattern with which it is removed is independent of the technique used to deal with the excess skin 'acreage'. The vertical scar technique using a superior or superior-medial pedicle produces an youthful, projecting breast shape that lasts for a long time. The Wise pattern, inferior pedicle technique is reliable and safe for women with very large breasts. Its shape tends to be a little 'boxier' and less projectile.
Liposuction can be used to contour the 'bra roll' portion of the breast, beneath the arm. Liposuction can also be used to reduce the breast volume, but of course, there is no tailoring of the excess skin or lifting of the NAC with this technique.