Anyone out there had breast reduction?

[redrig]

I've got a consultation with a plastic surgeon on Wed...I need a predetermination form and a letter of medical necessity to see if my insurance will cover it. I had a mastectomy about 12 years ago and after the reconstruction (tram flap) there's now about a 3-4 cup size difference and I'm sick of stuffing the small side to even the girls out.

If insurance says they won't cover it, anyone know how much (ballpark) this type of thing is? Obviously I'll be asking the doc, but wanted to know if anyone had experience. I'm hoping that since they only have to reduce one side I can get it half price :idea:

[cpbaby]

:hug

[sandooch]

I've had 2 breast reductions (the first one did not reduce them at all IMO, just lifted them). My second one was done 13 years ago and cost $5,000. I'm not certain if they'd charge you only half for one breast because most of the expense is for the anesthesia, which you'd need regardless of reducing one breast or two. Although the surgery would be shorter, so you wouldn't need as much. I would think they wouldn't charge you more than $3,000, especially now a days with our economy struggling; you'd probably get a good price.

I would also like to strongly suggest to make sure you get your pain medication prescription filled before the surgery to have on hand immediately after. I didn't do that and was in a lot of pain the first time around. Having to wait that 1 1/2 hours for the pharmacy to fill my prescription was pretty awful. The next time around I took the pills as soon as they released me from the hospital and it helped tremendously.

I hope I answered your question. Let me know if you need to know anything else and best of luck to you. My reduction (the second one that is) was one of the best things I've ever done.

[candygirl]

I had mine done in 2005, cost at about $12,000 ( I had a overnight stay).
From a 38DDD to 36C :dancing:

Considering your condition ,I don't see why your insurance won't cover it.

Good Luck !

[redrig]

I had mine done in 2005, cost at about $12,000 ( I had a overnight stay).
From a 38DDD to 36C :dancing:

Considering your condition ,I don't see why your insurance won't cover it.

Good Luck !

It's the "considering your condition"...I don't have back pain, I'm just sick of stuffing one side to have an even rack! Somehow I don't think that qualifies as "medical necessity". I'm hoping the plastic surgeon is skilled at writing insurance fiction!

[cabby92]

Reconstruction after a mastectomy should be covered. Even if it's not technically a reconstruction, it's making them match. I know my aunt had about four surgeries to get a decent look and insurance paid for all of them.

[sea-shell]

I just turned my paperwork into the insurance - well my plastic surgeon did - said I should hear in about 3 weeks if they accept it or not.

[ttistin]

I have not had one but man I want/need one. I can't stand being this large, hurt back, pain in the neck and shoulders. I know I am not near as large as some people but I would love to be a size C or smaller. Dh wouldn't be happy but I would be lol

Hope all goes well and you hear back from insurance soon :hug

[hotdoglove]

I didn't but my sister had one due to medical issues... She was a triple d or bigger when she was 16 so enough said.- I think she still has huge boobs lol... of course i'm just jealous cause I got the smallest out of 4 girls lol...
Hope you are able to get your insurance to pay!

[sunniekiss]

It's the "considering your condition"...I don't have back pain, I'm just sick of stuffing one side to have an even rack! Somehow I don't think that qualifies as "medical necessity". I'm hoping the plastic surgeon is skilled at writing insurance fiction!

You had better hope your surgeon is not skilled at writing insurance fiction b/c lying on insurance applications/forms is a federal offense.

With tha said my niece-in-law had this done @ 4 years ago & hers cost over $4,000. Insurance did not cover anything other that her antibiotics & paid meds.

Good luck & hopeing your insurance does pay for this.

[redrig]

Reconstruction after a mastectomy should be covered. Even if it's not technically a reconstruction, it's making them match. I know my aunt had about four surgeries to get a decent look and insurance paid for all of them.

I had reconstruction at the time of the mastectomy, but it was the one where thy use your stomach fat to build a new breast. And at the time, I weighed maybe 105, so there wasn't a lot for them to use. Even if insurance won't pick up the tab, I'm going to have it done and will figure out a way to pay. I'm sure the hospital will take a down payment and then monthly payments.

[hblueeyes]

If insurance denies you, I would appeal. It is reconstruction due to surgery to save your life. I know most do pay or at least they should. How can they cover men to have penial implants so they can have sex but not for your physical and psychological well being. I pray for you to stuff no more. No woman should have to endure what you are,

Me

[lkvf]

I would like to get a reduction as well. I have back and neck pains. How do I start the process, I'm hoping insurance will pay a well? Do I go to my gynacologist for a referral, or find a plastic surgeon? What is the recovery time? any suggestions would help.

[candygirl]

I would like to get a reduction as well. I have back and neck pains. How do I start the process, I'm hoping insurance will pay a well? Do I go to my gynacologist for a referral, or find a plastic surgeon? What is the recovery time? any suggestions would help.


Since most health insurance has become better at approving breast reduction surgery as not just a cosmetic surgery anymore.

You should not have a problem with having it done,since you are having neck & back pains. How about shoulder pains?

I went through my primary Dr.,who referred me to my plastic surgeon. my plastic surgeon took pictures & submitted the paperwork to my health insurance company and I got my approval in 2 weeks .

I would check with your GYN about giving you a written referral to a plastic surgeon,if you do not have a primary Dr.,it helps with the approval ,(I was told )

Recovery time varies ,I had no problems with my recovery ,but I did take a month off from work ,to rest & relax.

I am very,very happy with the results of my surgery,and would not hesitate to have it done again:dancing:

Go For It :dancing:

[lkvf]

thanks for all the info. I also have those dark lines on my shoulders from where the bra straps have dug into my shoulders.

[newwiccan]

I had mine done on Monday. I went from a 36F to a small C. My insurance paid for everything including the overnight stay since the pain meds were making me sick.

Good luck!!

[candygirl]

I had mine done on Monday. I went from a 36F to a small C. My insurance paid for everything including the overnight stay since the pain meds were making me sick.

Good luck!!



WTG ! :dancing::dancing:

[VenuStar]

I'm a 46F and would love to go down to a D again. I was a D in highschool...went to a DD with first pregnancy and stayed there. went to H with second one and back down to F after 19 months of breastfeeding....I need something done! All the comments and advice for redrig is helping me to decide to make an appt with my dr!

[buglebe]

I was a 34 DDD but as I have gotten fatter, I am a 42 c now. I would like to be an A and not have to wear a bra but them my stomach might stick out more than my breast.
My daughter had a breast reduction but she doesn't look smaller to me but she loves her girls now so it did so much for her self image it was worth it. She had the tummy tuck too and I wouldn't go through all that pain for anything.

[redrig]

Well my ins company claimed they didn't receive anything from the doc's office, which is a load of crap...since the doc's office told me the ins co also told them they didn't have a fax #, WTF? Called ins and got a fax number and also a service request number so they could enter it into the system IMMEDIATELY. They said a determination would be made within 30 business days. I ain't waiting that long...June 30th is the date I'm scheduling for surgery so I don't have to use short term disability. They also said it wouldn't matter if I had the surgery already or not before they made their determination. The doc's office will crunch the numbers for me and have them at my appt Wed...it's $6400 for both, so mine should be a little lower since it's only one.

I just have to make it perfectly clear to my parents that I DO NOT WANT them staying overnight at my house (I'm an only child and even tho I'm 43, they can be a little overprotective). This is something very personal and I want it to be just me and my kitty. Plus my neighbor said she'd be there if I needed anything.