Trends in insurance coverage for adolescent reduction mammaplasty

•Adolescent reduction mammaplasty are increasing components of pediatric plastic surgery practice.•Insurance preauthorization for reduction have increased over the past decade, and age cutoffs are becoming less frequent.•Insurance company and family income under $60K per year were independent predictors of preauthorization denial.•Criteria most cited for denials were lack of prior conservative management, age <18 y/o, and unmet minimum resection weight.