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American Association of Plastic Surgeons

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Streamlining Insurance-Based Breast Reductions
Suma Yalamanchili, MD, Elise Hogan, BS, Gabrielle Farley, BA, Sarah Beth Guibord, DNP, MSN, BSN, Sarah Strauss, DNP, MSN, BSN, Ryan Gobble, MD.
University of Cincinnati Medical Center, Cincinnati, OH, USA.

Purpose: To propose a streamlined process for insurance-based breast reductions.
Methods: This was a retrospective review of patients interested in breast reductions who presented to our academic institution from January 2020 through August 2021. Patients first attend a nurse practitioner class where they are screened prior to an in-person consultation with a nurse practitioner. Patient charts are reviewed with a surgeon prior to submitting to insurance. Once approved, patients are scheduled a visit with a surgeon.
Results: 371 patients were identified as enrolled for the class. There was a 28% no show rate for the class. 267 patients attended the class and 105 patients were offered an in person visit with a nurse practitioner. 14 patients no showed to the visit (13%). Average estimated gram reduction by the nurse practitioner was 450g. Average schnur was 718 grams. 59 patients were eligible for a surgeon visit, with a 5% no show rate. On average, the nurse practitioner estimation was 110g less than the surgeons' estimation. 47 patients underwent surgery. The nurse practitioner estimation was on average 280 grams less than the actual resection weight and the surgeon estimated reduction was on average 60 grams less. Major complication rate was zero.
Conclusions: A nurse practitioner is able to estimate a breast reduction gram reduction, thus decreasing the number of visits and no-show appointments for a surgeon.


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