What a Difference! - Columbia, MD

After having suffered for years with the pain of pendulous breasts - the back pain, the strap grooves worn in my shoulders, the skin problems - I decided to undergo a breast reduction. The surgery was a lot less painful than I had imagined, and recovery was pretty easy. I was back at work in a couple of weeks.

This was a very difficult decision for me, as I wanted to have insurance cover it and they had certain parameters you have to meet. I had to interview my physicians carefully, since I wanted not only a nice job and a short scar done, but not to wake up with tiny breasts. (When insurance covers they have to take a certain amount of tissue.) In the end I was able to find someone I trusted to do the surgery who did a short scar based upon a breast lift and seemed to be able to promise when I was done I would be about a "C" cup, which was great b/c I'm a size 14 and a "B" cup or "A" cup would be dispropriately small on top.

When it was done a few people noticed some "weight loss" but no one was able to pinpoint it.

I also had to lose fifteen pounds so that they would cover the surgery. I did it all and when it was said and done the insurance company rejected the claim. Eventually, because I am familiar with insurance policy, I was able to get the insurance company to cover the physician's fee but not the facility fee. Finally I got the whole thing covered by sending a complaint to the Maryland Insurance Commission.

So, some lessons: if you are getting estimates ask for the physician and facility fees. We had a very unexpected surprise in getting the facility fee bills sent to us almost immediately after insurance didn't pay and then having to fight with the hospital. I had the money to cover the physician fee but NOT the facility fee. Make sure you can cover the surgery if insurance won't cover it. I had followed all of their guidelines and they still found a loophole.

I am very happy I did the surgery. Today I am able to do a lot of things I couldn't before including vigorous exercise (running, aerobics. etc.) and wear normal tops instead of big loose shirts all the time. I've joined a gym and have been able to maintain my lost weight.