Prediction of Weight in Breast Reduction Surgery

Many studies showing the benefits of reduction mammaplasty have been reported; however, insurance companies have become more cost conscious and have made increasing efforts to deny this procedure. Spector and Karp [1] state that insurance companies often do not cover breast reductions that remove less than 1,000 g total (500 g of tissue from each side). However, their study shows that women who have less than 1,000 g of total weight removal, or even less than 750 g of totally removed, demonstrate “substantial relief of macromastia associated symptoms” and significant improvement in quality of life.

Seitchik and Schnur [2, 3] have recommended that the insurance companies base the minimum gram resection requirement on the patients weight and height rather than on an arbitrary number applied to all patients. Seitchik [2] found there was a correlation between body weight and a specimen weight of 0.68. He concluded that three levels of minimal volume resection should replace the one volume minimum. He proposed the weight resection correlations as follows: (1) Body weight less than 60 kg, 400 g resection. (2) Body weight 61–79 kg, 700 g resection. (3) Body weight >80 kg, 1,000 g resection. Schnur [3] gives percentiles of weight removal based on body surface area. The patient's body surface area, obtained by a graph of height and weight, determines the volume of breast tissue that must be removed to be above certain percentiles for all women having reductions. Below the fif h percentile is considered cosmetic, and above the 22nd percentile is considered medically necessary.