Timing of Pediatric Breast Reduction and Insurance Coverage: Single-institution Retrospective Study.

[BACKGROUND] Although long-term benefits of reduction mammaplasty have been proven, the appropriate age for adolescent reduction mammaplasty has been highly debated due to possible need for revision surgery. Practitioners often delay offering breast reduction to adolescents below age 18 based on presumed insurance denial. We reviewed trends in insurance denial at a single children's hospital to analyze whether age and/or insurance carriers have a significant impact on coverage of breast reduction.

[METHODS] A retrospective chart review from 2012 to 2022 of cisgender female patients with macromastia aged 12-20 years at the time of diagnosis was analyzed for differences in breast reduction insurance coverage based on age and body mass index at the time of diagnosis, referral to plastic surgery, and surgery.

[RESULTS] A total of 121 cisgender women were included. There were no significant differences in the mean ages of patients who underwent breast reduction versus those who did not (16.46 years versus 16.96 years, respectively; = 0.089), or in the mean body mass index for patients who did versus those who did not receive breast reduction (28.58 kg/m² versus 29.05kg/m², = 0.382). Furthermore, there were no significant differences in the proportion of patients undergoing breast reduction by age ( = 0.200) or by insurance class ( = 0.403).

[CONCLUSION] Although insurance varies with carrier, the present findings suggest that surgeons need not delay in facilitating preauthorization for breast reduction in symptomatic patients presenting anytime during their teenage years.