17yo DD wants elective surgery!

[curlyjbs]

My beautiful dd wants a breast reduction. There is nooooo way we can afford the $12K-$15K it will cost. She has talked about this surgery for 2 years now. We have been to the surgeon who says there are "some" instances" when insurance will cover it but he cant guarantee me it will be covered. If I had the money I would do this for her in a second!!!! My heart breaks for her every day! Shopping for clothes is a nightmare! Forget bathings suites! Bras run me around $80 each and they look like your grandmothers bra!!! White, tan, black - nothing cute, frilly or sexy for sure!!! I dread prom season in a few months!

Has anyone else gone through this procedure and had it covered? What did you do to make it happen?

I really want to do this for her......

 

[RitaE]

My sister had it covered - she had severe back pain.

 

[Kies99]

Have you contacted your health insurance company? They should have someone you can talk to about it.

 

[MEM]

My beautiful dd wants a breast reduction. There is nooooo way we can afford the $12K-$15K it will cost. She has talked about this surgery for 2 years now. We have been to the surgeon who says there are "some" instances" when insurance will cover it but he cant guarantee me it will be covered. If I had the money I would do this for her in a second!!!! My heart breaks for her every day! Shopping for clothes is a nightmare! Forget bathings suites! Bras run me around $80 each and they look like your grandmothers bra!!! White, tan, black - nothing cute, frilly or sexy for sure!!! I dread prom season in a few months!

Has anyone else gone through this procedure and had it covered? What did you do to make it happen?

I really want to do this for her......

My sister had it done and you need to justify it based on medical reasons - my sister had chronic back and neck pain from the weight of her breasts and that was enough for the insurance company. The reasons you describe above are all "cosmetic" and should be left out of any conversation about the procedure.

 

[HM]

The wife of a coworker had it done and was covered by insurance because of pain in the back and shoulders.

 

[RitaE]

My sister had it done and you need to justify it based on medical reasons - my sister had chronic back and neck pain from the weight of her breasts and that was enough for the insurance company. The reasons you describe above are all "cosmetic" and should be left out of any conversation about the procedure.

exactly.
She needs to show that it causes pain and discomfort - hampers her movement, makes it difficult to run or walk etc etc.

With the health insurance, stress heavily those types of reasons and not the image. We all understand that image is a huge deal in regards to self-esteem and how she feels - but it is going to get you nowhere with the health insurance. Don't even bring those things up with the health insurance company.

 

[NJGirl]

I see you are in NJ. I too thought there was nothing cute in the bra department for big ****s and was stuck with boring until I discovered Linda's in NYC. I went and had a fitting and had a great selection of CUTE!!!! Pretty! bras. www.lindasonline.com is the online store, but she has 2 actual stores in midtown Manhattan.

It was the best thing I ever did. And worth the trip to the city.

Hope this helps your daughter find some pretty bras!

 

[curlyjbs]

I realize those are "cosmetic" reason above. The surgeon said the ins would require her to try conservative methods first . She has been seeing a chiro weekly ($20 copay) for about 7mos. She has horrible back/neck pain, headaches, numbness in her hands. She's been to a dermotologist for the sores under her breasts. Its ridiculous! I don't know why the insurance thinks going to a chiro or physical therapy is MANDATORY to be considered for coverage? It wont make her breasts any smaller! The older she gets the worse it will be without the reduction. This isn't a "**** job" - She is only 17 and wears a 34GGG. (not a typo - 3 Gs). All of you who wear DD's+ take a look at your bra....you think it's pretty big right? Well, you have nooooo idea!!! Most people don't even realize bras go past the DDD's.

Sorry for the vent. It's just so frustrating!

 

[mjkacmom]

I had it done around the age of 20 - I think my parents actually made money from the insurance. I've never heard of anyone who was denied full coverage (same with nose jobs). Contact your insurance company. I don't know anyone who's had it done who regretted it at all.

 

[3boymthr]

My mom wore a size 34I (yup, 6 cup sizes beyond a DD) was also in to the $80 granny bras and had horrible problems finding clothes and had it done to reduce to a D and said it was the best thing she ever did. She put it off for years and years because she too couldn't afford it and she didn't have back pain so she didn't think it would be covered. Well, then I started working for an insurance company and found out that while it's the most common reason, back pain is not the only reason to get it covered - other medical problems caused by oversized breasts can include hip alignment problems, curvature of the spine, significant dents in the shoulders caused by the bra strap that have become permanent (my mom's dents were 1/2" deep), numbness or tingling in the fingers or hands, shortness of breath when laying down, skin issues.

As PP mentioned you have to have medical cause and you have to go thru a pre-approval process and this is one that turns a lot of people off - often photos of your DD's breasts sans clothing (no face photos though) as well as photos of her affected areas (shoulders, back) have to be submitted for review by the insurance company's medical staff and it also depends upon the severity of these issues. If the problems are deemed mitigatable with appliance treatments (i.e., a back brace if back pain) then they won't cover it.

 

[DISdreamin']

I had reduction surgery done nearly four years ago. It was the single best thing I have EVER done for myself. I had rashes every single summer, I had back pain (which, ironically, I didn't know HOW badly until after the surgery when it didn't hurt any more). Prior to surgery I was a 34K (and that is not a typo...H-I-J-K cup size) and I actually saved one of my old bras just because it was so flippin' huge. My HEAD could fit comfortably in it.

Keep up with what you are doing - document, document, document every chance you get. Call your insurance company and get pre-approval for a consult with a plastic surgeon. The surgeon will take photos, make notes and basically take it from there with getting pre-approval for insurance coverage, in my experience.

I got two consults before deciding on a surgeon. Make sure you do your homework, obviously. The surgery isn't really all that bad (not comfortable, but nowhere near unbearable even without pain meds after) and I couldn't be happier with the outcome. I am able to do SO many things now I couldn't have even considered before!

 

[Sadie22]

Could it be that the doctor is waiting until he is sure your daughter has finished developing?

Otherwise, have photographs been sent to the insurance company? Has the doctor sent a report? Have you talked to the insurance company regarding your child's medical need? Have you talked to the billing department at the doctor's practice? Insurance companies differ in what they require in the way of documentation. You can request that the doctor's office get precertification for the procedure. That way you get a predetermination of what they will cover. If the response not satisfactory, you can find out if additional documentation will help when you appeal to the insurance company for a re-examination of the facts.

Good luck.

 

[jbmom]

I had a breast reduction in my early 30s and I wish I had it done when I was in my teens. I was a 38J when I had the surgery and it was the best thing I have ever done for myself. My surgery was covered by insurance. My plastic surgeon took pictures and sent them to be approved, I never had to do anything else. My back pain, neck pain, headaches, shoulder indents are a thing of the past and I can't believe I lived with it as long as I did.

The day of my surgery my plastic surgeon told me he was going to give me headlights instead of turn signals and he did!

 

[Callymum]

I had it done, wish I had it done sooner.
I got it free because of -

1- Neck/ shoulder pain.
2- Sweat build up under the breasts cause sores and infections.
3- The Bras causing painful grooves in shoulders because of weight.
4- When running the Bra causes chafing/bleeding at edges of wire.
5- Headaches caused by the stress of the weight on neck/shoulders.
6- Depression caused by comments from Peers.
7- Loss of enjoyment of life because of complications from Breast weight/pain. (no school sports etc)

Hope this list helps.

 

[DISdreamin']

Anyone else noticing a recurring theme here? In my opinion this is NOT elective surgery, it is a quality of life issue that has both physiological and psychological impact.

If this is something your daughter wants and it seems genuinely warranted, don't let anything stop you from pursuing this ASAP! My issues started when I had my kids, but I waited years after the birth of my youngest to really pursue the surgical option. I only wish I had done it sooner.

 

[DVCBELLE]

I had one at 22 - wish I had at 18 when I first went to see about it! Insurance should definitely cover it and you should search for a doctor who will help you get it covered. Trust me -there are doctors out there who will help!

I will never forget the first time after my surgery that I walked by a boy I didn't know who smiled at me and said hi - I was in shock that I might actually be more than a pair of breasts!! It was more normal for me to get comments like "Nice t*ts". I know where you are coming from - nothing hurts the self esteem like comments from adult men to a teenage girls like that!!

 

[RitaE]

I realize those are "cosmetic" reason above. The surgeon said the ins would require her to try conservative methods first . She has been seeing a chiro weekly ($20 copay) for about 7mos. She has horrible back/neck pain, headaches, numbness in her hands. She's been to a dermotologist for the sores under her breasts. Its ridiculous! I don't know why the insurance thinks going to a chiro or physical therapy is MANDATORY to be considered for coverage? It wont make her breasts any smaller! The older she gets the worse it will be without the reduction. This isn't a "**** job" - She is only 17 and wears a 34GGG. (not a typo - 3 Gs). All of you who wear DD's+ take a look at your bra....you think it's pretty big right? Well, you have nooooo idea!!! Most people don't even realize bras go past the DDD's.

Sorry for the vent. It's just so frustrating!

It really sounds like she should be covered for medical reasons. Especially with the history of chiropractic visits and numbness and the dermatologist and skin irritations. That is all solid documented proof that she is having medical complications.

Don't take the surgeon's word for what the insurance company will do, talk with the insurance company.

 

[girli565]

I was planning on having it done about 2 years ago, I went for the consultation with the reconstructive plastic surgeon. He measured, weighed (I know, I thought it was nuts too lol), and took pictures. I showed him the marks my bras leave on my shoulders and the slight hunch the weight of the breasts were causing, he documented it all. I have severe neck pain and it can be attributed to the girls too.

All that had to be submitted to the insurance company and about 2 weeks later I was approved for the surgery. I ended up opting to try and lose weight first to see if that would help me, and ultimately it did so I haven't gone for surgery yet. I also wanted to wait until after I had children.

Maybe you should call your insurance and see if they'll cover it due to back/shoulder pain? I was shocked at how quick the approval was. I also suggest looking for a reconstructive plastic surgeon not a cosmetic center because your insurance might not cover it from a place like that. I treated it like a normal doctor, I had to pay a specialist copay when I went for the consultation.

 

[It'sWDW4me]

I realize those are "cosmetic" reason above. The surgeon said the ins would require her to try conservative methods first . She has been seeing a chiro weekly ($20 copay) for about 7mos. She has horrible back/neck pain, headaches, numbness in her hands. She's been to a dermotologist for the sores under her breasts. Its ridiculous! I don't know why the insurance thinks going to a chiro or physical therapy is MANDATORY to be considered for coverage? It wont make her breasts any smaller! The older she gets the worse it will be without the reduction. This isn't a "**** job" - She is only 17 and wears a 34GGG. (not a typo - 3 Gs). All of you who wear DD's+ take a look at your bra....you think it's pretty big right? Well, you have nooooo idea!!! Most people don't even realize bras go past the DDD's.

Sorry for the vent. It's just so frustrating!

My sincere sympathies to your daughter. I cannot IMAGINE the torment she's endured.

Have you contacted your insurance company about having the reduction covered? All of the physical distresses you've mentioned above SHOULD qualify coverage but I would think that the emotional distress caused by her size should be mentioned as well. Heck, she's 17! DD's are cause for teasing & taunting - I can't imagine what she's heard about her GGG's!

Call your insurance company. If they say "no", call again, and again....

 

[girli565]

Call your insurance company. If they say "no", call again, and again....

This is the best advice on dealing with ins companies. If one person tells you no, ask for someone else, or a supervisor, or that person's supervisor. There's always someone above the person you're speaking to unless you get to the president of the company