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Disfigured patients may be forced to forego surgery

ific procedures due to contractual (insurance plan) language with no opportunity to appeal. At least one national company has excluded breast reduction surgery as a covered benefit.

Breast reduction and breast reconstruction procedures dropped 7 percent and 8 percent respectively in 2004. Facing large price tags for these medically necessary procedures, patients may be forced to live with painful medical conditions or disfigurement.

"The increase in denials and the advent of excluding procedures by insurance companies is a possible explanation for the decrease in reconstructive procedures," said Michael Sadove, MD, American Society of Maxillofacial Surgeons president. "We are working to have better relationships with third-party payers to help them have a greater understanding of the difference between reconstructive and cosmetic procedures. Part of this is an education of third-party payers and the other part is educating the public."

ASPS offers the most reliable statistics on plastic surgery procedures to date. Since 2003, statistics have been collected through the first online national database for plastic surgery procedures called Tracking Operations and Outcomes for Plastic Surgeons (TOPS). This data combined with the annual survey sent to more than 17,000 board-certified physicians in specialties most likely to perform plastic surgery results in the most comprehensive census on plastic surgery procedures.


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Contact: LaSandra Cooper
847-228-9900
American Society of Plastic Surgeons
16-Mar-2005


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