Back to 2026 Abstracts
Modified Robertson vs. Wise Pattern Breast Reduction in Pediatric Patients: A Propensity-Matched Analysis of Early Institutional Experience
Garvey Cummings
*, Miriam Meghnagi, Jacob R. Thomas, Gustavo Capone, Eric C. Liao, Cassandra A. Ligh
Division of Plastic, Reconstructive, and Oral Surgery, Children's Hospital of Philadelphia, Philadelphia, PA
Background:
The Wise pattern is the most commonly used technique for reduction mammoplasty within pediatric and adolescent populations. The Modified Robertson (MR) horizontal incision technique has demonstrated reduced skin breakdown when compared to the Wise pattern in adults; however, this comparison has not been evaluated in pediatric patients. We compare postoperative outcomes between MR and Wise pattern breast reduction in a pediatric cohort.
Methods:
A retrospective review of breast reductions performed between 2020 and 2025 was conducted. Patients were categorized by operative technique and propensity-matched by age and body mass index (BMI). Perioperative characteristics and postoperative outcomes were collected. Multivariate logistic regression was performed to identify predictors of complications.
Results:Among 153 total breast reduction patients, 26 patients who underwent MR were propensity matched to 26 who underwent Wise pattern reduction. The MR cohort had a higher average sternal notch-to-nipple distance (33 cm vs 29.25 cm, p=0.126). Overall complication rates were lower in the MR group compared with the Wise group (19.2% vs 46.2%, p=0.075), with significantly reduced odds of complications on multivariate analysis (adj OR=.26, p=0.039).
Wound dehiscence rates were lower in the MR cohort (15.4% vs 30.8%, p=0.324), as were hypertrophic scarring rates (3.8% vs 19.2%, p=0.191). After adjustment for sternal notch-to-nipple distance, the association between the MR technique and reduced overall complications was further strengthened (adj OR=0.13,
p=0.022).
Conclusion:The MR technique represents a safe and effective alternative to the Wise pattern for pediatric breast reduction, particularly in patients with greater ptosis. With a consistent trend toward fewer postoperative wound complications, MR should be considered as part of the surgical armamentarium for pediatric reduction mammoplasty.
Back to 2026 Abstracts
