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POSTED UNDER Breast Reduction Reviews REVIEWS

Breast Reduction & TT scheduled!!- Houston, TX

ORIGINAL POST

Have an appt with the PS on the 23rd. Really...

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Journey to a better body
Have an appt with the PS on the 23rd. Really hoping my ins (Aetna) will cover some. Anyone have any problems with the ins approval?
I've had large breasts since I was about 12 years old & I've always hated them. It's hard to work out or do anything. Lots of pain in my neck & shoulders. Just hoping for an approval!

Replies (20)

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October 16, 2013
Just had mine on Monday (14th)...GO FOR IT! Hopefully your insurance will cover it, mine didn't but I did it anyway. So glad! I went from 40DD/DDD (I too had one bigger than the other) to what will hopefully be 40C. I'm on the mommy makeover page, cause I plan to do a Tummy Tuck once I heal from reduction AND lose some weight. Good luck!
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October 16, 2013
Thank you! What ins do you have? Congrats to you!!!!
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October 16, 2013
It's United Healthcare, thru my husbands work. They don't cover ANY plastic surgery unless it's reconstructive (like after breast cancer or something). I didn't teen try to file for it. I called them, and the answer over the phone was no. Plus, my issue is primarily the sagging/look. THAT, and the fact that I never wanted anything more than C-cup, lol. Thanks to having kids, that dream was shot, haha. Anyhoo, it was still worth it, paying for it myself. It was $6400, which is right in the normal cost range for this kind of procedure (reduction, no lift).
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October 16, 2013
I'm glad you were able to get it done. I'm sure it's so much better now. Do they look good when you don't do a lift? I guess I just assumed everyone did a little lift with a BR.
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October 16, 2013
I think some/most do a lift as well. I chose not to, because my reduction isn't as significant as ones I've seen (over DD/DDD cup). But mostly because I just wanted to be smaller and nipples moved up...not as concerned with lift/height. Its definitely a personal choice. Best to chat with your doc, he can advise what to do based on what you want your outcome (look) to be.
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October 16, 2013
Oh okay, got it. I have my appt with the PS next Wed. I'll def be going over all this. Can't wait to see your follow pics. Good luck with the recovery & thank you!
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December 10, 2013
I'm trying to get mine approved through Aetna, too. Aetna received everything November 4th, and I'm still in review...even after the rep said the review process is 15 business days. I hope you have better luck!
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December 10, 2013
I just got my approval last weekend!!!!!! I am scheduled for March 7th for that & a tummy tuck. They give you the approval for 6 months so I've decided to do it during Spring Break so my little ones can stay with grandma. So excited but scared at the same time. It took exactly 4 weeks to get my letter. I'm sure they'll approve you. Good luck!!!
December 10, 2013
Hi all, I have Aetna HMO through Exxon and it's got really great coverage. BUT they are a little more complicated to get a BR approved through. If you haven't gotten the document, I can send it to you but based on your BSA (body surface area) you have to have so many grams per boob removed. For me it was about 650g, but my PS only wanted to removed 500g. So it was originally declined but I was able to get it approved on appeal.
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December 10, 2013
Mine was approved. I believe mine is a little over 500 per breast that has to be removed. What size were you before? What size are you now after the 500 being removed?
December 10, 2013
I haven't had my surgery yet, it's in 4 days!! EEK! I'm a 34h/36g, but with 500g to be removed I'll probably be a 34dd/36d. I'm glad yours got approved. I have a feeling they just wanted to make me jump through some hoops since I also put in for a panniculectomy (which typically also includes a tummy tuck). They approved the skin removal but not the TT, but the whole tummy procedure is only going to be $500! I've already bought a ton of bras to have on hand to try one. I don't want to go to the hassle of going to the mall/store over the holidays and then not have my sizes in everything :)
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December 10, 2013
I'm scheduled but I'm debating it. I am a 38DDD so that would bring me to a B probably. I'm Not sure I'm ready for that. I'd like to be a C. That's freaking awesome!!!!! All that for $500 is sweet! I have a $1500 deductible so that's what I'll be paying for the BR & $7000 for the TT.
December 10, 2013
Good luck, my PS refused to take out any more than the 500 because he doesn't want to make me too small. I would be happy with a C, but I'm sure it'll be a full D/DD depending on the bra :)
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December 10, 2013
I'm trying to lose some weight before then so it'll drop the amount that has to be taken even lower. They also said he can go 50g less on each side need be. Good luck on your surgery! Please update!!!
December 10, 2013
I'll def update. I dropped 10lbs from the original pre-cert request and the appeal, so my requirement dropped to 590 and I think aetna thought that the allowance was okay since my history of issues was so long in comparison to the 18% weight difference... you could always wait until after the TT (if you're having Lipo) because that'll DEF help with the BSA and resubmit the request.
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December 10, 2013
I'm not having lipo & I'd really just like to go under the knife once, lol. Do you think they'll have to resubmit my approval if I lose weight? I just assumed if I lost they would just recalculate.
December 10, 2013
Well I actually submitted for a Pre-cert before the procedure because I didn't want to take any chances. If you were approved at 500g, I think you'd have to take out the 500g to be approved right away. I would think that if you lose more weight before the surgery and go ahead with it and the Dr. takes out less that 500g that you might get denied based on your original submission, but you could appeal based on your new information and would probably be approved. I just couldn't take that risk. Just give aetna a call and ask them what happens if the PS takes out less or if your stats change. I've found that they can be pretty helpful. If you don't get any answers let me know and I'll check with my Nurse Coor - she might be able to answer for us.
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December 10, 2013
Yikes! Now I'm scared to lose weight, lol. I'm going to call the PS today & ask them. If they can't answer it I'll call Aetna. Thanks!
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April 3, 2014
My back and neck pain has disappeared after having this surgery. Best choice I've ever made! Look forward to following your journey :)!
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April 3, 2014
Awesome and thanks! How many grams per breast did they remove?