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About The Schnur Sliding Scale

Dr. Brenner frequently see patients in consultation for breast reduction surgery. Even though most patients have decided that they want to proceed with breast reduction surgery before they even meet with him, nearly all of them want to know if their operation is medically necessary.

Further, and maybe even more importantly, his patients want to know if their insurance company will approve their surgery as medically necessary. These are not one and the same. Our insurance authorization team works tirelessly to get medically necessary operations approved prior to surgery and we have a very good track record of doing so.

We know what insurance companies cover

The reason we are so successful is that we know what procedures insurance companies consider medically necessary and we are keenly aware of criteria healthcare providers require.

Further, we do not waste time attempting to get unjustified surgical procedures approved.

How The SchnurSliding Scale Is Used

When it comes to breast reduction surgery it takes good surgical judgment and a fair amount of experience in order to know ahead of time, the correct tissue amount that will need to be reduced from each breast.

Further, as a plastic surgeon, Dr. Brenner must also determine ahead of time the amount that he believes a patient’s insurance company will require that he remove in order for it to be considered a medically necessary procedure.

One tool that is useful in determining the “minimum required amount” of breast tissue that should be removed is the Schnur Sliding Scale.

What Is The SchnurSliding Scale?

The Schnur Sliding Scale chart is an evaluation method used with individuals who are considering breast reduction.

This method was developed by a plastic surgeon who was studying women who had breast reduction surgery for medical reasons. The patients body surface area and average weight of breast tissue removed is incorporated into this chart.

If the patient’s body surface area and weight of breast tissue removed fall below the 22nd percentile, then the surgery is deemed cosmetic in nature, and therefore not medically necessary.

If however, these two factors are above the 22nd percentile, then the operation is considered medically necessary when the appropriate criteria are met. Not sure what your BSA (body surface area) is? Calculate it here.

CLICK HERE TO CALCULATE YOUR BSA

Body Surface Area

Average grams of tissue per breast to be removed

1.35

199

1.40

218

1.45

238

1.50

260

1.55

284

1.60

310

1.65

338

1.70

370

1.75

404

1.80

441

1.85

482

1.90

527

1.95

575

2.00

628

2.05

687

2.10

750

2.15

819

2.20

895

2.25

978

2.30

1068

2.35

1167

2.40

1275

2.45

1393

2.50

1522

2.55

1662

2.60

1806

2.65

1972

2.70

2154

2.75

2352

2.80

2568

2.85

2804

2.90

3061

2.95

3343

3.00

3650

3.05

3985

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Body Surface Area

Average grams of tissue per breast to be removed

3.10

4351

3.15

4750

3.20

5186

3.25

5663

3.30

6182

3.35

6750

3.40

7369

3.45

8045

3.50

8783

3.55

9589

3.60

10468

3.65

11428

3.70

12476

3.75

13619

3.80

14867

3.85

16230

3.90

17717

3.95

19340

4.00

21112

4.05

23045

4.10

25156

4.15

27459

4.20

29972

4.25

32716

4.30

35710

4.35

38977

4.40

42543

4.45

46435

4.50

50682

4.55

55316

4.60

60374

4.65

65893

4.70

71915

4.75

78487

4.80

85658

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History of the Schnur Scale

Insurance companies rely upon the Schnur Scale to determine patient eligibility for breast reduction surgery, but what is the history behind the scale? In 1991, a study was performed to determine whether reduction mammoplasty was most often needed for purely cosmetic reasons, or if the procedure was to address the range of medical conditions overlarge breasts can produce.

Cosmetic or Medical? Your Insurance Company Wants to Know.

A percentage of patients wanted breast reduction surgery as a physical enhancement, and others were suffering painful medical problems from having overly-large, heavy breasts. This study revealed that a majority of women seeking breast reduction surgery (78 percent) sought the procedure to resolve a medical condition, rather than for cosmetic reasons.

Determining Eligibility for Breast Reduction Surgery

The scale was developed to determine the quantity of breast tissue that should be removed in breast reduction surgery. Women who had excess tissue in a quantity that fell within a specific category of percentage of breast tissue to be removed could be considered eligible to have the surgery covered by health insurance. We work closely with our patients to help them through the complexities of working with a health insurance company to get a procedure approved for medical reasons, when possible.

Breast Reduction Surgery: Quality of Life

Women who live with heavy, overlarge breasts struggle with many uncomfortable symptoms. Beyond the practical issues of difficulty in fitting bras and clothing, the pain and discomfort caused by heavy breasts can be debilitating. Reducing breast size to a size that creates a balanced, attractive look can greatly improve quality of life. The release from back pain, neck pain, rashes, and the ability to participate in sports, exercise, and social activities without pain or embarrassment are all important ways to increase pleasure in daily living – and we can help.