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POSTED UNDER Breast Reduction REVIEWS

New Body Under Construction - Greensboro, NC

ORIGINAL POST

I'm a 32 year old mother of 2 (ages 5 and 8) who...

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PurplePassion81
WORTH IT
I'm a 32 year old mother of 2 (ages 5 and 8) who has spent the last 8 years catering to everyone except myself. That's changing. I deserve to be happy and healthy so I'm embarking on a weight loss and body reconstruction journey. Today I had a breast reduction consultation with a plastic surgeon referred to me by my PCP. My hope is that health insurance will cover the surgery. I'm currently around a 44DDD...probably a little larger but I haven't been measured in a while. The consultation left me hopeful although at first I was slightly apprehensive about the PS (he's 73 and there was no website available so I could view his work). He was thorough in answering my questions and saw the discoloration under my breasts as well as the groove marks on my shoulders. My weight/BMI *may* be an issue but it's something I'm working on anyway. I'm 5'5" and 225lbs. He agreed to try to get my surgery approved. So after my examination, he measured me, had the nurse take pictures and then I was able to review some of his work in photo albums. The nurse told me that he'll need to complete dictations before submitting to my insurance company and then after that, we'd have to wait for a response. She suggested getting a letter from another medical practitioner to strengthen my case and to also write a personal letter to go along with it, which I thought was an awesome idea. I actually have an upcoming appointment with my gyn in 3 weeks. She's been suggesting a breast reduction for the past 6 years so I don't think she'll have any problem giving me a recommendation. So that's it! I need to review my insurance policy to see how much deductible and coinsurance I'd be responsible for. In the meantime, I'll continue to work on my weight. My goal is to be 200lbs by September 2014. Wish me luck. Photos to come soon!

PurplePassion81's provider

Howard Holderness, Jr., MD

Howard Holderness, Jr., MD

Board Certified Plastic Surgeon

PurplePassion81

PurplePassion81 rating for Dr. Holderness:

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Replies (6)

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May 29, 2014
Good Luck on your Journey!!! I am thrilled I finally got mine approved from my insurance initially denied me I appealed and it was overturned in my favor.Some insurances have a clause stating it needs to be medical necessity and I had to meet there critera. But Im 6 weeks post opt
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May 31, 2014
Wow! You are healing nicely and I love your bright colored bras. I'm longing for the day I can purchase a regular sized bra in a regular store in fun colors! I'm expecting a denial initially so it's good to know an appeal can get me the answer I want. Thanks :)
May 31, 2014
Good luck with the weight loss, I know you can do it so just stay focused.   You are going to feel so much better when this is done.
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June 25, 2014
Thank you so much! It's a process but I'm looking forward to how much better my back and neck will feel, not to mention how much better I'll look in clothes.
June 25, 2014
Yes, this is a process so take it one day at a time.  You got this girlie!
February 22, 2017
Hi Im desperately trying to get breast reduction surgery but i dont no where to begin anymore. I went to the hospital in Winston Salem NC and they told me they don't accept medicaid but I also have champ va. It frustrated me so bad that I actually gave up. But by the grace of God he restored me and filled me with energy and determination to start looking again but I'm not from NC and it's so different from Jersey. So I pray someone can help me find a dr. because I'm in unbearable pain EVERYDAY ALL DAY to the point it brings me to tears cause it hurts soooo bad and won't nobody help me. So if you or anyone reading this can someone please help me. My name is Andrea and I can be reached at 3362857510 and I live in greensboro NC. Congratulations to you and I pray that everything will turn out fine for you. I'm so desperate to get this surgery because it feels like this pain will kill me. Thank You and Good Luck!!
UPDATED FROM PurplePassion81
2 months pre

APPROVED!!!!

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PurplePassion81
So this morning, the secretary from the doctor's office called to tell me that BCBS has approved me for surgery!!!!!!!!!! Whoop! I was like "nuh uh! You're lying to me!!" LOL Of course after the initial shock, I thanked God. I was so expecting a fight with insurance and multiple denials and appeals. I didn't even submit my personal statement or a recommendation letter from my GYN, so it was approved based on the plastic surgeon's recommendations from my consultation. The best part is actually my insurance coverage. The secretary informed me that I would only owe a $200 deductible plus 10% coinsurance and that my pre authorization is good until mid September. The only thing I have to do know is look over my calendar and pick a few dates that might work. Dr. Holderness (the plastic surgeon) performs surgeries on Tuesdays and Thursdays. They have to check to see the surgery center will have availability on one of the days I prefer. I'm beyond excited and hope to schedule sometime at the end of August to accommodate my work schedule. Beyond excited!! :)

Replies (2)

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June 25, 2014
I am a size 42DDD and I weighed at the time of my consultation I weighed 209, I'm now 205. I thought that my pain was associated with my weigh because I was so over weight (257 pounds). Lost weight and pain got worst. And like you was referred to a PS. So I'm like you and want to be under 200 by surgery. I have until the 16th. I think you will be able to lose the weight you want and some in the time frame you have. Congrats on your approval and good luck!
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July 1, 2014
Thank you! My goal is to be under 200lbs too. Good luck with the progress
UPDATED FROM PurplePassion81
2 months pre

Some pics

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PurplePassion81
So I've finally built up the courage to post some pictures. You may not be able to tell but I have shoulder grooves & suffer from neck & back pain which is worse during high impact exercise. I also have started experiencing a weird sharp pain sensation in my breasts occasionally. The last bra I bought was 46DDD although I'm probably bigger... I've just been refusing to buy up any higher.

Replies (7)

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June 30, 2014
I know what you mean about those shoulder grooves when exercising.
June 30, 2014
Congrats
June 30, 2014
I had a consult on June 23rd through Favor I pray BCBS will pay for mines. I have been struggling with very large breast for the 15 years. I am 5'5 200lbs and I know BMI I can't exercise too much because of my enormous size breast are constantly hurting I wear a 38 M. My bras cost $60 a pop but they fit I don't have that extra hump in the front like I have 4 vs 2 breast. I go to sophisticated bra specialty in Burlington Nc, Erica is great . Well again congrats and I am waiting in limbo.
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July 1, 2014
Hopefully things will turn out in your favor! And even if not, appeal & go for it again. Never heard of that bra shop but I may need to check it out. I last bought my bras from lane Bryant (cacique) but before that I was spending a fortune at the department stores on big ol ugly beige bras.
July 1, 2014
Thank you hopefully with the Federal BCBS plan I have they will see the pic and my medical records and see the need but I will keep appealing if denied I won't give up without a fight. This not cosmetic but medical. I am about to start juicing to lose the weight also so between this website and you tube about juicing I am consumed lol good luck with that also.
June 30, 2014
Hi PurplePassion. I was wondering what insurance you had. I have BCBS of NC. I have my inital appointment this Wednesday to see my PS. I'm getting really excited and I hope that this insurance will cover it. The last insurance that I had was CIGNA and they said that they no longer covered BR surgery. I have been trying since February to get this surgery. We just switched to BCBS so I'm hoping that this one pans out.
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July 1, 2014
Hi wannabesmaller, I have BCBS but the coverage really depends on your employers plan & how extensive it is. I used to work in claims/benefits for united healthcare. My husbands employer happens to have an awesome plan through bcbs with very good coverage. Go ahead and submit & even if its not approved, appeal & do it again. They count on you giving up. One thing that was suggested to me was a personal statement letter to accompany the PS notes & recommendations. It may sway things in your favor for whoever the preauthorization person is who'll be reviewing your info. Good luck to you!