How Medical Necessity Is Determined for Breast Reduction Surgery
If you’ve been living with chronic neck, shoulder, or back pain caused by large breasts, or you struggle with rashes, posture issues, or discomfort with daily activities, a breast reduction may bring relief.
While the procedure can have significant health benefits, not every breast reduction is automatically deemed “medically necessary.” Both your surgeon and your insurance provider may refer to the Schnur Sliding Scale to help determine your eligibility for insurance coverage.
This guide will walk you through what the Schnur Sliding Scale is, why it matters, and how Dr. William Bruno approaches breast reduction surgery, keeping your health and comfort in mind.
What Is the Schnur Sliding Scale?
The Schnur Sliding Scale (SSS) is a medical guideline used to compare your body surface area (BSA) to the estimated amount of breast tissue that would need to be removed during surgery.
Essentially, it’s a chart designed to help determine whether a breast reduction is considered reconstructive (medically necessary) or cosmetic (elective).
If the estimated amount of tissue to be removed falls above a certain percentile on the scale, typically the 22nd percentile or higher, insurance companies are more likely to consider the procedure reconstructive and approve coverage.
A Brief History
The Schnur Sliding Scale was developed in the early 1990s by Dr. Paul Schnur, a plastic surgeon who surveyed over 200 colleagues to understand the relationship between a patient’s body size, the amount of tissue removed, and whether the surgery was performed for medical or aesthetic reasons.
His research helped standardize how insurers and surgeons assess medical necessity for breast reduction, but it’s important to remember that the scale is a guideline, not a rule.
How Dr. Bruno Uses the Schnur Sliding Scale
At his West Hollywood practice, Dr. Bruno uses the Schnur Sliding Scale as just one part of a comprehensive evaluation. He also considers:
- Your physical symptoms (pain, rashes, shoulder grooving, or breathing difficulty)
- Your body frame, posture, and proportionality
- The potential improvement in your quality of life
While the scale provides a numeric reference, Dr. Bruno’s recommendations are always personalized. His focus is on helping you feel more comfortable, confident, and supported, whether your motivation is medical, aesthetic, or both.
Reconstructive vs. Cosmetic: What’s the Difference?
Reconstructive breast reduction surgery aims to alleviate physical symptoms and improve your health. Patients often report dramatic relief from back and neck pain, improved posture, and greater ease with movement.
Cosmetic breast reduction focuses primarily on reshaping or refining the breasts for aesthetic balance, often when symptoms are mild or absent.
If your measurements fall within or above the 22nd percentile on the Schnur Sliding Scale, your surgery is more likely to be categorized as reconstructive, and therefore more likely to be covered by insurance.
(Your specific insurance provider may have additional requirements or documentation standards.)
Will Insurance Cover My Breast Reduction?
Every insurance company has its own guidelines, but coverage typically depends on both your symptoms and your position on the Schnur Sliding Scale.
Dr. Bruno and his team can help you gather the information your provider may need, including:
- Detailed medical history and symptom documentation
- Estimated tissue removal amounts
- Preoperative photographs, if required by your insurer
While Dr. Bruno cannot guarantee approval, his office will guide you through the process and provide the documentation necessary to support your claim.
Dr. Bruno’s Approach to Breast Reduction
Dr. Bruno takes pride in offering personalized care. From your consultation through recovery, you’ll work directly with him, not a rotating team. Each step is designed to ensure you feel informed, comfortable, and confident in your decisions.
His focus is on natural results and wellness-driven outcomes, helping you achieve a breast size that feels in harmony with your body and supports a healthy, active lifestyle.
Schedule Your Consultation
If you’ve been struggling with pain or discomfort from overly large breasts, it may be time to explore your options. During a private consultation, Dr. William Bruno will listen to your concerns, review your goals, and determine whether breast reduction may provide both medical relief and aesthetic balance.
Contact Dr. Bruno’s West Hollywood office to learn more about the Schnur Sliding Scale and your breast reduction options.
