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POSTED UNDER Breast Reduction REVIEWS

43 Years Old... Very Nervous - Boston, MA

ORIGINAL POST

I have wanted... No, I have needed a BR for many...

Toonervous03
I have wanted... No, I have needed a BR for many years. I developed in my teens and although not unbearable I was always considered the girl with the large breasts. Fast forward.... I had my first child at age 20. I gained a lot of weight. I am about 5'5" and weighed about 120 before pregnancy and the day I gave birth I weighed in at 199 lbs!!! It took me a long time lose that weight but unfortunately my boobs remained big. I have since have had 2 more children and my breasts continued to grow with each one. I hAte them. I can't sleep comfortably, I have neck and shoulder pain, back spasms, I often wear 2 bras at one time. The majority of my friends and family think I am crazy. They say women would kill to have your breasts. Or they will say " you don't even look that big!" It is very frustrating. I don't look that big to them because I do everything in my power to minimize them which includes being in a constant slouch position which has completely ruined my posture, they are heavy.. So heavy! Anyway, I have contemplated a breast reduction for years. My PCP has always thought I would benefit from having the surgery. Finally after years of thinking about it I finally made a decision to go for consultation. The PS I went to was very nice. I measured at the time as a 38DDD. He said he could take me to a C. But he said he would try and submit to insurance but he was not confident it would be covered. After a month of waiting I got word that I was denied! The insurance company said they felt the amount being reduced would not significantly improve my quality of life... I appealed with letters from my PCP and a letter from me explaining what I go through daily but in the end I was denied. needless to say I was vey depressed. I gave up the notion.... Fast forward 4 years. I am still miserable. I think my breasts have increased but I refuse to get measured and refuse to buy bigger bra's. I have a different insurance... anthem... So I thought I would try again. My PCP gave me a letter explaining my symptoms, what we have done over the years to relieve the pain ( pain medication, physical therapy, massage, exercise, weight loss etc.) I decided to see a different surgeon... A women. A friend of mine had a reduction by this surgeon and very pleased with results so I figured I would give it a shot.
I was quickly able to get a consult. She was extremely nice... Went over options, measured me took pictures etc. she immediately thought I would be a good candidate and would submit to insurance. I walked out of their feeling relieved and excited but did not want to get my hopes up as I have been disappointed before.
The office said it takes about 30 days to hear back from insurance. It was a very long month.... After about 20-25 days I called insurance company to get status... They informed me that they have no record of receiving anything from my PS!!! Ughh how can that be? I was so upset. I called my Ps office and left a message... No one called me back. 2 days later I called again. I finally reached someone who checked and said my file was just sent to insurance the previous week... So give insurance some time to receive... A week later I logged onto my insurance carrier portal and sent them an email asking if anything was received. 2 days later they responded... Still nothing received and suggested it could of been lost in mail. They told me to have the PS office call them and they will give them a private fax where they can fax over the file. So. Frustrating! This is about the time I found this website and I have to say it has helped me a lot!!! Anyway, I received notice about 2 weeks ago that the insurance company has the info and my case is being reviewed.... So I wait. Now I know I am suppose to wait 30 days but I have been very anxious so I logged onto my insurance portal about a week later and asked if my case has been reviewed and when I could expect a response. On 03/17 I received an email response back from my insurance stating " your predetermination case has been reviewed and approved as of 03/16/2015!!!! WHAT????!!!!! I don't know what that means? Am I approved for the surgery???? Does anyone know? I called my PS and left them a message telling them what I was told .... Have not received a call back. I have not received anything yet in mail from my insurance company either... I don't know what this all means. So now I wait ?? Impatiently of course. What do you ladies think.....does this mean I am approved? I thought I would give my PS until Monday to call me back as I was hoping by then I would receive an approval letter in the mail. I will have to wait and see. I will check back in when I know more!

Toonervous03's provider

Sonal Pandya, MD

Sonal Pandya, MD

Board Certified Plastic Surgeon

Replies (4)

March 20, 2015
It sounds like you approved
March 20, 2015
I would wait for written confirmation from the insurance company that you are approved. And then KEEP that confirmation in a secure place so that if anything comes up in the future, you have proof that you were led to believe you were approved. I don't want to discourage your PS choice, but if it took them this long to get you approved, you can also expect them to take as long with billing and other issues. Your PS may be fantastic, but the headache of constantly badgering the billing office/admin staff may not be something you want to deal with post-op. Just a caution...good luck to you!
March 21, 2015
Thanks... I will keep that in mind!
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May 31, 2015
Your reduction looks amazing!!!!! I have been wanting one myself for awhile now but am nervous about the results I see. Usually it looks like the nipple is too high and flat, or mismatched, or too low to look like anything was done. Could you share the doctor you used? I am trying to narrow down a choice for my future br doc.
UPDATED FROM Toonervous03

Spoke to insurance carrier today!

Toonervous03
So I was going to wait until Monday to call my PS to hear what they had to say. Had they received confirmation from my insurance carrier and what are next steps... They are closed on Fridays or I would have done it today. Anyway, I decided to call my insurance carrier. I spoke with a very nice women who confirmed that YES I was approved for a breast reduction. I was so excited but then she said I was approved to have it done by March 31!!!! Umm hello... It's March 20 right now and I haven't even received this approval in writing yet nor have I even spoken to my PS office. I asked what happens if I can not have the procedure done by the 31st.... She said it should be fine and that me or the PS office just needs to call them with the new date. Okay, so I feel a bit more relieved. (Btw, I should be receiving written authorization early next week as well)Wow this is really happening. I normally don't like the weekends to go by so fast , but I can't wait until Monday to talk to my PS!!!! Talk with you all soon!!!

Replies (3)

March 25, 2015
I knew was approved. I have my be surgery Apr.15
March 26, 2015
2 days before mine! Keep me posted! And good luck
March 26, 2015
I sure will
UPDATED FROM Toonervous03

Surgery date

Toonervous03
Well it's official. My surgery is april 17. I can not believe it. I love reading everyone's stories as it is such inspiration. The problem is I think I have literally read them All and I want more! You ladies have been so great and full of encouragement.

I think my biggest fear is infection and wound separation. I have read numerous stories where these unfortunate incidents occur and I am so worried. What is the best way to avoid this. I can't wait for the smaller me but I am so scared.

Anyone have words of encouragement?

Replies (5)

March 27, 2015
I'm scared too my biggest fear is getting put to sleep
April 1, 2015
Very few people have complications. I'm not worried about my upcoming surgery on 4/21. I'm more concerned about healing and handling going back to work only two weeks after surgery. Focus on the big picture and how much better you'll feel and look.
April 17, 2015
Yes, I agree complications during surgery are rare. The healing process is what concerns me as well. Tomorrow is my big day!
April 17, 2015
I hope it went well today!
April 18, 2015
Thanks... So far so good