title: Breast reduction scars: a prospective survey of patient preferences.
abstract: BACKGROUND
  Studies have shown that scarring is a primary reason for patient dissatisfaction with reduction mammaplasty.
  
  
  OBJECTIVE
  The authors prospectively evaluated patient preferences for the 3 most common breast reduction scar patterns: horizontal, vertical, and Wise.
  
  
  METHODS
  Sixty-six patients were recruited for the study before receiving their reduction mammaplasty consultation. Each patient was shown line drawings and postoperative photographs of the 3 breast reduction techniques and scored the scars on a modified 10-point Likert scale (1 = unacceptable; 10 = acceptable). The survey responses had no impact on the patients' medical care. A nonparametric Friedman test was used to compare the mean scores, and univariate generalized linear regression analysis was performed to adjust for confounding factors. Post hoc analysis was performed using the Bonferroni method. Significance was set at P < .001.
  
  
  RESULTS
  Sixty patients completed the study. The mean preference ranking was significantly higher for the horizontal scar pattern versus vertical and Wise (P < .001). The mean score difference between the horizontal and Wise patterns was 2.982. The mean difference between the horizontal and vertical patterns was 2.27. There was no significant difference in preference between the vertical and Wise patterns. Linear regression analysis showed that age, body mass index, and torso/bra size had no significant effect on preference.
  
  
  CONCLUSIONS
  To our knowledge, this is the first study designed to prospectively evaluate patient preferences regarding postoperative scars. Results indicate that the horizontal technique is preferable with respect to scar placement.
authors.affiliation: Division of Plastic Surgery, Department of Surgery, University of Ottawa, Ontario, Canada.
authors.forename: Colin P
authors.initials: CP
authors.lastname: White
authors.forename: Hana
authors.initials: H
authors.lastname: Farhang Khoee
authors.forename: Abdullah E
authors.initials: AE
authors.lastname: Kattan
authors.forename: Farough
authors.initials: F
authors.lastname: Farrokhyar
authors.forename: Nicolas M
authors.initials: NM
authors.lastname: Hynes
mesh_terms: D000328:Adult; D049628:Body Size; D002921:Cicatrix / Q000209:etiology* / Q000517:prevention & control / Q000523:psychology; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D016014:Linear Models; D016462:Mammaplasty / Q000009:adverse effects* / Q000523:psychology; D008875:Middle Aged; D009864:Ontario; D057240:Patient Preference; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
keywords: Wise pattern reduction; breast reduction scars; breast surgery; horizontal pattern reduction; patient survey; reduction mammaplasty; vertical pattern reduction