Has anyone had reduction surgery?

[Sherri]

I was just wondering if anyone had reduction surgery before and if so how long did it take until insurance preapproved it?
I went a little over 7 weeks ago to the PS and the person in the office said I should no within 3-5 weeks. The wait is awful. My upper back is hurting me so much and if for some reason insurance doesn't approve it I wonder what else they will do. I want this done very badly.
Has anyone else had this experience before?
My Primary Doctor and plastic surgeon both thought I would be an excellent canadate for this. I just wonder what is taking so long for insurance approval.
Any help or insight would be so appreciated.

 

[drgnfly30]

A friend of mine did... it did take a long time to get the approval from the insurance company but eventually they granted it... she also had horrible back pain, deep indentations in her shoulders from the straps etc... The 'girls' look great & she's never been happier!

Now if I could just find a way to make a tummy tuck "medically necessary"!

Good Luck!

 

[Sherri]

Actually if you have a lot of loose skin in the belly area that keeps causing rashes and infections, your Doctor may put the tummy tuck in as medically nessasary.
I'm glad your friend got approved for the reduction. The waiting is the worste especially when I am trying to plan my summer.

 

[pajamommy]

I had my surgery done in Oct. 2001. I think it was about a month or so before I heard if my ins. approved it, obviously they did! It was the best thing I ever did for myself. If you have any other questions, feel free to PM me....good luck!

 

[Good Ol Gal]

I too had this surgery. I've been Over the Rainbow for 2 years now. By far the BEST thing ever for me!!

I was approved within 30 days from our insurance co, but no one told me until I called back 6 months later to check on the status of it.

You can also PM me with any questions or concerns.

 

[Mermaid02]

I really want this done. My dh says it's a terrible thing to do to a "perfectly good breast" but I'm telling ya- my neck and back hurt, clothes NEVER fit me right, I have huge indents in my shoulders and the list goes on and on. I need to lose weight first, but then I'm going to look into it. Thinking about a tummy tuck at the same time so I only have to go "out" once.

Keep us posted!

 

[OhMari]

I had it done 20 yrs ago this week. I came out of the hospital May 4. I was in for 4 days. Now they have you in/out in one day. It does not hurt at all. There will be drainage and you have to go back to get the tubes out.

I remember I wore a size 12 wedding dress and I was crying because I had to wear such a big dress. The seamstress told me "Dolly Pardon" makes a lot of money off her looks. Who wants to look like Dolly. 20 years ago, clothes were not made decent for people in their 20's. The only shirts I could find were Granny blouses. I started buying shirts in the men's department.

It was the best decision I have ever made.

 

[jamzots]

I am also considering having this done...have been putting it off because I'm scared of the pain and anesthesia. Plus I want to find a really good surgeon. Maybe now I will look into it!!

 

[Sherri]

Thanks everyone for all the information and support.
I am a 40DDD (yikes-even typing it looks so big)I don't have a huge frame, I am a size 8 and 10 depending on what style clothing it is. I hate the pain in my back. Its tough sitting on the bleachers watching my childrens sports because of the strain. I want to feel comfortable in my body again. I really hate the waiting. I feel like I will be so let down if it isn't approved.

 

[Mickey&JoshNut]

I too have had this surgery....10 years ago....it was the best thing I ever did...I can't answer your question about insurance coverage as I am in Canada and my surgery and aftercare was all covered by our provincial medical coverage.

 

[Chris2597]

What is the criteria for breast reduction as far as insurance goes....My gyn told me that she thought I would be a good candidate...My neck, back and shoulders hurt all of the time....and when they start...my headaches start....I have also started getting a drop to the knees shooting pain in my shoulder....It literally will take my breathe away....I have put off checking this out further because of fear of surgery, pain and mostly insurance denial.

 

[denise5374]

I just got the approval from my insurance co a couple of weeks ago. I am scheduled for surgery on 6/2/06.

I have thought about it foe years and I finally had the nerve to go to a plastic surgeon in my network (I have Blue cross/Blue shield Personal Choice). He did a consultation and took photos (YUCK) and submitted to my ins co. I waited about 3 weeks for the decision, the nurse called me and told me they approved it.

the questions the Dr. asked me were if my back hurt, neck hurt, if I got rashes under the breasts. He also did the height/weight thing, apparently if you are overweight there is less of a chance that the surgery will be approved, the thinking is that if you lose weight "they" will go away too. I am slighly overweight for my height but I told him that I cannot exercise because of the discomfort. I think it also has to do with "drooping" and how much tissue needs to be removed. He is taking 800g per side out, I will be a C when finished.

My Ins also pays for an overnight stay in the hosptial. I hope to only be out of work for a week. SOmetimes the surgery is done as outpatient.

If you have any other specific questions, I may be able to help.

 

[hemispheredancer]

My BCBS insurance required a 500 gram (about 1 lb) removal on each side. That wasn't a problem for me since he took out almost 4 lbs. I had a reduction and lift. The girls are where they should be and I am in proportion now. I was a 42FF before and now a 42D. DH didn't want the surgery since those were "his". Too bad for him since he wasn't the one carrying those monsters around. It was the best thing I did. The only regret was that he didn't take enough. I had a drain in each breast until that evening and then he came in and took them out. I was released the next morning with a rx for Darvocet that was never used. The anesthesia was well tolerated. I was under for almost 5 hours. They gave me shots of Demerol afterwards but I don't know why since I wasn't in pain. The whole recovery was pretty much pain free. No regrets at all!

 

[denise5374]

Hemispheredancer-

How long ago did you have the surgery? How long until you felt "normal" again?

That sounds similar to mine. I think 800g per side is about 3.5ils, if my math is correct.

Thanks!

 

[hemispheredancer]

I had mine done Jan 03. I was ready for Victoria's Secret bras after about 6-8 weeks. What a great moment that was. The scars are so faded now that you can't tell they are there. I had the "lollipop" incision. Be sure to find out how they will do yours. You want minimal scarring. Any other info I can help you with?

 

[Denine]

I had this surgery in 2000. It took me a while to get insurance approval, but I did and they paid for everything. It is the best surgery I ever had!

I did have to do a bit of leg work to get approved. I wrote them a letter stating why I needed the surgery, basically "a day in the life" kind of letter. I also had my orthopedic surgeon send them a letter. I had back surgery when I was 17 and had seen him a couple years before my reduction for mid back pain.

Some people need to go through an appeal process if the get rejected.

Whatever you do, don't give up. It is sooo worth it!

 

[julia & nicks mom]

I had one 11 years ago -

I went to the doctor and the next day my insurance approved me - my mom called to talk to the claims approval department to see how long it would take for approval and the lady pulled my file and approved it -

have you tried calling them?

As for everyone who wonders if they qualify - most doctors know the language to use for insurance approval - but when you go in make sure you tell the doctor you have back pain & shoulder pain

it was one of the best things I ever did!!!!

 

[Sherri]

I just got the approval from my insurance co a couple of weeks ago. I am scheduled for surgery on 6/2/06.

I have thought about it foe years and I finally had the nerve to go to a plastic surgeon in my network (I have Blue cross/Blue shield Personal Choice). He did a consultation and took photos (YUCK) and submitted to my ins co. I waited about 3 weeks for the decision, the nurse called me and told me they approved it.

the questions the Dr. asked me were if my back hurt, neck hurt, if I got rashes under the breasts. He also did the height/weight thing, apparently if you are overweight there is less of a chance that the surgery will be approved, the thinking is that if you lose weight "they" will go away too. I am slighly overweight for my height but I told him that I cannot exercise because of the discomfort. I think it also has to do with "drooping" and how much tissue needs to be removed. He is taking 800g per side out, I will be a C when finished.

My Ins also pays for an overnight stay in the hosptial. I hope to only be out of work for a week. SOmetimes the surgery is done as outpatient.

If you have any other specific questions, I may be able to help.

Hi- I to am from suburban Philadelphia. My Doctor is in Paoli (chester County).
I have blue cross health plan east.
How long did it take to get approval? Did you call your Doctor and follow up or did they call you as soon as they new?

 

[Sherri]

Oh okay, I reread. You were approved in 3 weeks and nurse called you. You are lucky. I just check my blue cross claims on line it said nothing the surgery, only about past claims. I thought that was strange. You would think it would have said it someplace in my records. I e-mailed bluecross to check on the status. If I don't hear back then I will call.
Thanks everyone for the great advice and help.

 

[Sherri]

I had one 11 years ago -

I went to the doctor and the next day my insurance approved me - my mom called to talk to the claims approval department to see how long it would take for approval and the lady pulled my file and approved it -

have you tried calling them?

As for everyone who wonders if they qualify - most doctors know the language to use for insurance approval - but when you go in make sure you tell the doctor you have back pain & shoulder pain

it was one of the best things I ever did!!!!

I called my insurance company directly this morning, the pre quailifacation department. I am so upset I can't even tell you. I was actually crying because the whole 7 or so weeks I have thought the ball was rolling on this. It turns out that they don't even have a record of the request. So what happand to the pictures the Doctor took? And now if they were lost do I have to get more done and do I have to wait over another month for approval? I can't tell you how much pain I am in. I feel really let down by the Doctor. The Docctor is in a nice area and probably gets people coming in paying cash and getting all sorts of things done that my procedure is just a drop in the bucket to him, had I known this I would have gone somewhere else. The really nicel lady at Bluecross that I spoke to said that it is procedure for them to get a call from the Surgeons office, but not one call was made. I am having a really bad morning and now I have to go to work and put on happy face and I am in tears. And yes I no there are worst things in life. If anyone could give me any advice as to where to go from here I would appreciate it.