A Novel Approach to Breast Ptosis in Reduction Mammoplasty: Outcomes of the Paisley Pattern Incision.

Breast reduction mammoplasty incision patterns vary in benefits and drawbacks. The Wise pattern enables lateral skin resection but leaves medial and lateral scars, while the Vertical pattern yields a smaller scar yet limits lateral skin removal. A novel, Paisley pattern allows lateral skin resection without a medial scar. This study compares postoperative outcomes of the various techniques. A retrospective chart review of 118 patients undergoing bilateral breast reduction mammoplasty from January 2020 to November 2024 at a single institution was performed. Demographics, comorbidities, operative details, and 60-day complications were collected. Analyses included chi-squared tests, ANOVA, and -tests. Of 118 patients, 60 (51%) underwent Wise, 44 (37%) Vertical, and 14 (12%) Paisley reductions. The Paisley group had the highest BMI (35.5 ± 5.5), significantly higher than Vertical (31.3 ± 4.4,  = .005) but not Wise (33.8 ± 4.6,  = .204). Operative time was shortest for Paisley (2.47 ± 0.41 h) versus Vertical (3.05 ± 1.06 h) and Wise (4.71 ± 1.97 h), significant between Paisley and Wise ( < .001) and Wise and Vertical ( < .001). Paisley had the highest resection volume (2026.9 ± 780.6 g), greater than Vertical (1137.3 ± 624.7 g,  = .03) and comparable to Wise (1860.1 ± 866.1 g,  = .423). Complication rates were 36.4% Vertical, 21.4% Paisley, and 14.8% Wise; no Paisley patients required revision surgery. The Paisley pattern offers comparable complication and reoperation rates, shorter operative time, and greater resection volume, with technical and aesthetic benefits.