Reducing Plastic Surgery's Silicone Footprint: Modeling Shipping Costs for Breast Implants and Tissue Expanders.

[BACKGROUND] In the traditional ordering model, plastic surgeons often request 3-4 different sizes of implants, tissue expanders (TEs), and sizers per procedure and order duplicates as backup. This can result in large orders, ranging from 15 to 32 items, with most of the materials remaining unused and ultimately being shipped back to the manufacturer. This study aims to quantify the costs incurred by shipping materials used in breast augmentations and reconstructions.

[MATERIALS AND METHODS] A model was constructed to tabulate annual shipping costs, built upon key inputs for annual ordering volumes and shipping rates that were obtained through secondary sources (e.g., courier websites, American Society of Plastic Surgery [ASPS] statistics data), as well as implant/TE sizes and weights. Extreme and conservative scenarios of ordering behavior were simulated in the model to deduce an expected range and most realistic median figure of annual shipping costs.

[RESULTS] In the base case scenario where three sizes were ordered for all cases using overnight shipping, the total shipping costs for 2023 were $125.3 million. Compared with this, choosing ground shipping for three sizes cost $34.5 million (72.5% less), while ordering four sizes with overnight shipping cost $173.4 million (38.4% more).

[CONCLUSIONS] Implant/TE shipping costs are significant and can total tens to hundreds of millions of dollars depending on the shipping type and total sizes ordered. These costs are handed down to multiple stakeholders in the healthcare system, including physician practices, implant companies, and patients. The results of this study may encourage the use of more cost-efficient methods to decrease overall waste.