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Cosmetic surgery thrives, while reconstructive surgery falters, statistics say

Ambulatory Surgery Reimbursement Update, April 12, 2005

Optional cosmetic surgery has become one of the medical industry's fastest-growing subsections in recent years. The popularity of changing physical features to enhance self-esteem or even job prospects has grown, fueled by our desire to chase perfection.

Conversely, reconstructive plastic surgery has become harder and harder for many Americans to acquire, according to a recent statement by the American Society of Plastic Surgeons. The ASPS says that reconstructive procedures such as breast reduction and reconstruction, tumor removal, cleft lip and palate repair, burn care, hand surgery, and other procedures that can bring far more value to a disfigured patient's life than a collagen injection or a tummy tuck, saw a 10% decline in 2004. The decline is mostly attributed to restrictive policies by insurance companies concerning these life-changing procedures.

"This new data is concerning because we don't believe there are less reconstructive procedures that need to be performed," said Scott Spear, MD, ASPS president, on the organization's Web site. "We are not positive, but we have some concern the insurance market is suppressing the ability of patients to get needed reconstructive plastic surgery procedures. Going forward, we want to make sure that reconstructive surgery continues to be covered by insurance."

In the past, reconstructive procedures denied by insurance companies were generally open to appeal, provided that the patient could support the medical benefits of such procedures. Now, according to the ASPS, many companies eliminate coverage of specific procedures with no opportunity to appeal.

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