POSTED UNDER Breast Reduction REVIEWS
35 Years Old, No Kids, 5'8" and 145 Pounds, Hopefully Finally Going to Get my Breast Reduction!!!
ORIGINAL POST
I've been doing a lot of research on this site and...
WORTH IT$6,200
I've been doing a lot of research on this site and everyone is so helpful with showing their before and after photos, so I decided to post some before photos myself.
I kind of did things a little backwards since I found a plastic surgeon that was covered by my insurance and made an appointment with her for December 16, 2016 and THEN I asked my Primary Care Dr (who I've only seen once and didn't mention getting a breast direction with her before) if I could schedule an appointment with her, and hopefully get her (my PCP) to write a letter of recommendation for me getting the procedure done through my insurance company, which is UPMC through "Obama Care" (not Medicaid or Medicare though).
I'm afraid that because I'm so thin that my boobs (mostly just my right one really, size 32FF or 32F) aren't big enough (I'm pretty sure my left one, a 32G, is big enough) and that I won't be able to get enough grams removed to satisfy the insurance company. I want to go down to a small C if possible.
I looked up what my UPMC insurance needs in order for them to approve it and they want months spent at a chiropractor and other forms of trying alternate methods to make sure it's my huge breasts and not something else, even though I've been a size C in like 6th grade and now I'm at a G and I've hated them my whole entire life. I'm not one to show them off, I continually hide under men's extra-large Hoodies because if I wear anything tight fitting the attention is relentless. It's really embarrassing.
So my question is this: At my size do you think I qualify for a breast reduction? And also, is there anybody else that just had a letter from their plastic surgeon and maybe their primary care doctor along with photos (obviously) and were you approved with just those three things?
I kind of did things a little backwards since I found a plastic surgeon that was covered by my insurance and made an appointment with her for December 16, 2016 and THEN I asked my Primary Care Dr (who I've only seen once and didn't mention getting a breast direction with her before) if I could schedule an appointment with her, and hopefully get her (my PCP) to write a letter of recommendation for me getting the procedure done through my insurance company, which is UPMC through "Obama Care" (not Medicaid or Medicare though).
I'm afraid that because I'm so thin that my boobs (mostly just my right one really, size 32FF or 32F) aren't big enough (I'm pretty sure my left one, a 32G, is big enough) and that I won't be able to get enough grams removed to satisfy the insurance company. I want to go down to a small C if possible.
I looked up what my UPMC insurance needs in order for them to approve it and they want months spent at a chiropractor and other forms of trying alternate methods to make sure it's my huge breasts and not something else, even though I've been a size C in like 6th grade and now I'm at a G and I've hated them my whole entire life. I'm not one to show them off, I continually hide under men's extra-large Hoodies because if I wear anything tight fitting the attention is relentless. It's really embarrassing.
So my question is this: At my size do you think I qualify for a breast reduction? And also, is there anybody else that just had a letter from their plastic surgeon and maybe their primary care doctor along with photos (obviously) and were you approved with just those three things?
EGBR's provider
Replies (34)
November 8, 2016
I'm in the same boat. No documentation, just waiting to see if I get lucky, lol. I'll pay out of pocket I don't even care. I'm sick of these DDD's!!! Good luck!
November 11, 2016
I wish I had the option to pay out of pocket, but I have sooo many other hospital bills and student loans, it sucks. Hopefully I'll have the stamina to keep on fighting the insurance, so I'm expecting to be denied, and then I'll have to do physical therapy to show I'm trying arterial methods, and possibly see a chiropractor, too. It sucks and is expensive, trying to prove to the insurance company that it's your breasts and nothing else that is causing you pain and discomfort.
November 11, 2016
My reduction was just approved! I am actually shocked because I only sent pics and the plastic surgeons letter, I didn't even see my primary! It's crazy how different insurances are! I understand about the debt. I don't have the money either, it'll be a loan from my hubby's retirement account:/ I still have a $3,000 deductible that I have to pay, on top of my monstrous monthly premium! it sucks to be in chronic pain when it's obvious why, yet they are too cheap to pay out. So frustrating. I hope it works out for you! Keep doing what you're doing and I'm sure you'll get covered. :)
November 11, 2016
Well, those are words well worth waiting for, although I imagine you're in the minority; I'd be over the moon with joy if my insurance company just approved me with photos and a letter from my plastic surgeon, even though I'm starting physical therapy next week just to show the insurance, "Look, I'm trying other avenues besides surgery to alleviate my back pain. Oh what a surprise, it's not working lol." I don't think my deductible is that high, even if it is I'll try and somehow work with it.
November 11, 2016
I heard something that might help your case. I believe there is a law of some kind that mandates insurance companies to cover breast reconstruction or reductions if a woman's breasts are uneven in shape and size. If you have this problem at all, I would stress this point to your surgeon to be included in the request sent to insurance. Emphasize the difficulty of having breasts that aren't completely even on top of their enormous size and the pain they cause. And I think I said this before, but you being slim helps your case, not hurts it. I know many overweight or obese women who were told they had to lose weight and prove their breast size wouldn't shrink with the rest of their body. I hope this helps!
November 11, 2016
It couldn't hurt to play up their disproportion to not only one another, but more importantly my body as a whole. I'm hoping that my plastic surgeon tells me exactly how many grams she plans on removing during surgery from each breast; I'm also hoping that that amount is substantial, and not only 300 grams (I think my insurance needs 350 grams taken from each breast, anyway) but something like 500 or so. The first hurdle though is getting the insurance to pay for it. I wish I had the money to do it myself, and I would but I'm paying off all sorts of other bills right now. I'm hoping the insurance doesn't tell me to lose weight because like a lot of other women on here, weight can fluctuate all it wants but I always stay a 32/34 G. I'm at a healthy weight anyway, so I guess all I'll have going for me is the letter and photos from her.
November 11, 2016
Even if insurance says only 300, that is just their minimum. The surgeon can take out much more than what insurance says is their minimum. My insurance set a minimum of 500, which is about two cup sizes, which would bring me to a DDD. I would like a D cup!
November 11, 2016
Well, I'd like to go from a 32G to a 32C (small C if possible) so you figure that's (C, D, DD, E, F, FF, G) down 6 cup sizes for the bigger one, maybe more like 5 for the right breast. Don't even know if that's possible, but I won't know until I ask. I'm just tired of waiting!
November 11, 2016
It is possible! My surgeon says she will aim for a cup size between C-D, since of course they can't promise a specific size, but I will be going from a G down to a D or C. 500 grams is about 1 lb, so 1 lb from each breast minimum will alone be amazing. I can't wait.
November 16, 2016
I hope you get better luck than me, mu insurance had denied me, despite letter of recommendation from my obyg, ps doctor and i letter from my self explaining about my physical therapy done for about 6 weeks. They said i need to be in physical therapy from 3 to 12 months, evaluated by doctor for at least 1 year, pain medication for 3 months, massages, special support bra.... as you know i have a long journey!! Very frustrating but that's exactly insurance want me to be, so i can give up.
November 16, 2016
Yeah, that sounds about right (meaning what the insurance company wants you to have to do to prove that you're in pain and that the surgery is medically necessary). I'm fully expecting to be denied by my insurance, but there's always hope so I'm gonna go see a plastic surgeon December 16. The plastic surgeon will write me a recommendation and take photos, which she will send in to the insurance company. I know it's gonna take more than that though. Good luck with your journey,
November 17, 2016
I don't think my insurance requires that, but I've read so many stories on here that some other peoples insurances require them to be on pain meds for three months,
November 17, 2016
Some insurances do, but I don't think mine does. Still, since I don't look that big since I have a small frame, they'll probably automatically deny me. They want to see me doing physical therapy, going to my doctor for a while (like 6 months), wearing supportive bras, seeing a chiropractic for a certain number of months, etc. It's still pretty ridiculous, but if insurance will pay for it than I'm willing to do all that.
November 18, 2016
I just had surgery 1 week ago and had to jump through every hoop to get it covered by insurance. Twelve weeks pt, letters from primary care dr, obgyn, chiropractor, surgeon. After 3 denials it was finally approved. Such a headache, but so glad I did it.
November 18, 2016
How long did you have to do do all that extra stuff (PT, chiropractor, etc) and how many times did you
November 20, 2016
I saw obgyn once, orthopedic surgeon 2 times with X-rays (at start and end of physical therapy), chiropractor 1/mo for about 6 months, physical therapy 1/week for 12 weeks, primary care doc once. It was absurd, especially since I eventually met my out of pocket maximum and they are paying way more than if they had approved it the first time. I think my insurance just wanted me to give up.
November 20, 2016
I don't even have a OB/GYN doctor, or a chiropractor, or an orthopedic surgeon! Looks like trying to get the insurance to pay for my breast reduction is going to cost me probably around a grand or so, depending on the co-pays and how often I go to these people. When I see my plastic surgeon in a month, I don't think it would make any difference at this point to have my Primary care physician write me a letter because I've only seen her once complaining about neck and back pain. And I've only gone to physical therapy two times in one week. Even if I sent them letters, the insurance company would still say that I've got to do physical therapy for at least three months, and they want a letter from a chiropractor or another doctor that you've seen to try to alleviate your back pain, which is stupid because everybody knows it's my boobs! That's what I've heard from a lot of people actually, about the insurance making you jump through so many hoops. If you keep being persistent about it, you'll eventually get them to pay for the operation. The people that don't really need it for medical reasons though, I guess the insurance figures that not everybody will be persistent unless they actually need the surgery.
Replies (7)
November 7, 2016
The left breast, the bigger of the two, is a G so therefore I wear G cup sized bras, and the right one is a FF, which is one size smaller than a G cup in the European brands I wear in bras....can't wait to not have to do THAT anymore, either!
December 20, 2016
We are virtually the same before size with the same level of asymmetry and the same age! I am 3 weeks post op and am down to a 32D. Swelling is almost all finished. It was the best thing I have ever done for myself. Good luck to you:-)
December 21, 2016
That's pretty cool that we're so similar to each other, I was looking for you when I first joined because it seems that everybody I found on here was like super short and morbidly obese. I'll have to check out your review, if you have one, when I get home from work. I'm happy to hear that you were able to go down to a D, because when I first started this journey I wanted to be a B cup. That's too much reduction though, so I'd be happy with a C or a D. Actually, one step at a time lol, I can't wait to get approved by insurance! Hopefully I'll have my surgery in February.
December 21, 2016
Not sure if I mentioned it before, but glad to know that you were able to go down to a D cup. I think I'd be pretty happy with a D cup, especially considering how small around I am, although sometimes I wear a 34 it just depends on how much I weigh at the time although cup size always stays the same.
December 23, 2016
I can tell you this, they took 330 grams off the larger breast and 150grams off the smaller. I may even be down to a large 32C once healing has finished. Although calling a 32C large compared to what I was wearing sounds funny! I think I'll be fairly close to symmetrical once everything has settled down. I'm not sure what it takes get coverage outside of Canada. Breast reductions are covered under our universal health care system.
UPDATED FROM EGBR
4 months pre
Appointment with my primary care physician today, wish me luck!
Hey everybody. Still big chested and miserable, but I have my first appt. with my doctor today who will hopefully tell me that she thinks I need a reduction and will write me a letter of recommendation to the insurance company. I'm just really worried she won't since when you initially look at my breasts they don't LOOK huge because I'm a thin framed woman and not overweight, but they're still massive on my body. I looked up my insurance requirements for getting it done, and as far as actual weight goes, they want at least 350 grams removed from each breast, or 700 grams total. I know my bigger, left breast will meet those requirements no problem, but I'm worried about my right breast which is much smaller.
As a side note, it's frustrating being at a healthy normal weight and feeling like nobody takes me seriously when I tell them I'm a 32FF/32G. Just because I'm relatively thin doesn't mean my boobs don't cause me as much emotional discomfort and physical pain as heavier women. Furthermore, I'm afraid that the one person/people I need to take me seriously (the insurance company) won't simply because I'm not overweight and my boobs don't hang down to my wait band. I guess the first step is getting my doctor to take me seriously, but we'll see if my fears are going to be comfirmed in a few hours when I go see her.
As a side note, it's frustrating being at a healthy normal weight and feeling like nobody takes me seriously when I tell them I'm a 32FF/32G. Just because I'm relatively thin doesn't mean my boobs don't cause me as much emotional discomfort and physical pain as heavier women. Furthermore, I'm afraid that the one person/people I need to take me seriously (the insurance company) won't simply because I'm not overweight and my boobs don't hang down to my wait band. I guess the first step is getting my doctor to take me seriously, but we'll see if my fears are going to be comfirmed in a few hours when I go see her.
Replies (7)
November 4, 2016
How did your appointment go? I'm currently in the same boat. I got a denial letter today. So far I've only been to the plastic surgeon who sent in my request. I guess now that I got denied, I need to get my letters from PCP , see a chiropractor etc. May I ask you, when you called your PCP, what do you say you are making an appointment for? I have no idea how to go about it. Just say you want an appointment to discuss a breast reduction and need a letter? lol Help! :D
November 4, 2016
I posted an update publicly since what I wanted to tell you personally and what I wanted to say in general are kinda the same thing, but to answer your question though, yeah I just called my PCP's office and essentially said what you wrote, "Hi, I'm a patient of Dr. So and So, and I'd like to schedule an appointment with her to discuss breast reduction surgery, and if she would write me a letter of recommendation to the insurance company." I was able to see her within two days of calling, which was nice; I'm having to wait two MONTHS to see this plastic surgeon lol.
I'm also sorry you got denied, that's the whole reason I'm trying to get as many doctors behind me as possible, so I have more than just the letter from the plastic surgeon being sent off to the insurance company.
I'm also sorry you got denied, that's the whole reason I'm trying to get as many doctors behind me as possible, so I have more than just the letter from the plastic surgeon being sent off to the insurance company.
November 4, 2016
Awesome, Good luck! Such a pain!!! I hate waiting and I have no patience LOL!
November 4, 2016
Wishing you the best. You have the right to have the body YOU feel most comfortable in. So gang in there and best sure your wishes are understood by your surgeon. Good luck!
November 4, 2016
Thank you Mary! I'm not seeing my surgeon just yet (six weeks away yet), but I'm starting the whole process right now and hopefully this all results in me being able to live a life pain free, among other concerns.
November 6, 2016
From my experience, you being thin might actually help you out with the insurance company. For larger women, insurance companies often tell them to lose weight because then their breast size and pain might go down. For a slender person, there isn't much to blame except the boobs and you can't put your boobs on a diet!
November 6, 2016
LOL! "You can't put your boobs on a diet!, "That's absolutely hilarious. Seriously though, if I could just cut the damn things off without feeling any pain, I probably would've done that like 15 years ago. I hope me being lean helps me out with the insurance company, but like I think I said before, my boobs aren't hanging down to my knees. A lot of the bigger women have boobs that go on forever, and mine are obviously pretty damn big for my size. But after they look at a stack of papers where the women are 5 foot two and weigh 285 pounds, my case might not look quite as drastic.
As far as knowing what I want after surgery, I'm going to make sure to show my plastic surgeon plenty of pictures and be very clear in saying I don't care how small you have to make me, just make sure to take enough to get it covered. Even though I'm tall, I think I'd still look good with a small B cup since I'm not overweight. Plus, I've read that as you get older, they tend to get a little bigger anyway since most people gain weight as they age anyway, so if I were to put on like 15 pounds in ten years, I'd still only be a C cup or something.