How is that even possible? Is it cause the average age is someone well past their bikini days? I don't get why someone would do this on an 80 year old.
If your SS cases are taking more than 40 minutes (in my opinion) you've done something wrong leading up to those cases. Maybe not enough training with staff (all players) and dry runs with surgeon? My first 15 cases were all 40 minutes or less and that is skin to skin. In my experience with proper preparation these cases are quite easy.
I would like to hear thoughts from other CSR's with SS accounts.