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POSTED UNDER Breast Reduction REVIEWS

WAITING for BCBS Fed to Review my Docs for Approval. Currently 32DDD or Larger? 5'2"135lbs 40 (Almost) Mom of 1. Greenville, NC

ORIGINAL POST

Hoping for approval, been waiting since July 3...

DlbfAugust 31, 2014
$6,950
Hoping for approval, been waiting since July 3 (consult) after 3 weeks I called PS office, apparently not all of my info had been sent to ins. Ugggg! According to the sliding scale I'd need 310 removed. The PS had estimated 250. Back, neck, shoulder pain. Numbness in hands that's not carpal tunnel.

Replies (7)

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MsBobcat
September 1, 2014
My PS sent my info into BCBS fed in summer, took a month from 1st consultation to get all info together because prior mammogram was out of state and needed new mammogram and comparison. From that about one more month for BCBS fed to send letter 8/11 in usmail from "plan utilization" dept saying approved for procedure expiring Dec. 31. Then PS office called same day to tell me they got their approval ins copy and they could schedule in three weeks. My size is 42DDD, but likely bigger cause that is squeeze, doctor measured for more accuracy for ins. And nips are lower than 11" than shoulder. I am 5' even and PS office staff kind of gave impression that for my height 5' that More than DDD was within criteria. She did not say outright, but I got that impression. And BSBC fed DID aprove, so going in.3 days for BR. So from 1st consult it took 2 months to get approval letter, but time factored in for the mammogram appt. Be patient, good luck.
Dlbf
September 2, 2014
Thank you! It's SO hard to wait! They didn't ask for my most recent mammogram? Wonder if they will?? That will just hold it up a bit longer! I kind of think the PS office didn't send my paperwork when they said they did. Glad to know that they will approve some of us shorties! Lol with the total amount to be removed it puts us in a bad position because of our size we don't have the same weighted breasts as someone taller (usually anyway) thanks for giving me a glimmer of hope! :)
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MsBobcat
September 2, 2014
My job related med clearances required mammograms AFTER age 40, am now 52, so maybe not required yet for you unless any issues found in annual well-woman exam
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MsBobcat
September 19, 2014
My bcbs fed approval had required 580 each side...PS staff got on the computer calculator and said that would bring me to a full C. I ask PS to go smaller and he removed 800 each side. I am super pleased with the result and am still round and not too tiny, just right. Talk to your PS again...250 or 310 sound like hardly anything to me...personally I would not think that would be must smaller. 200 grams is just about one cup size, I would not go through all this healing just to reduce one cup size. Ask what size generally estimated that 500 would bring you to. I did ask my PS what he did relative to insurance requirements, and he said he made his medical decision in surgery for best of patient and was willing to justify his judgement to the insurance companies afterwards in behalf of his patient. I liked his willingness to fight on my side.
Cree11
September 1, 2014
Good luck!! We had similar stats. I was a 32F 130lbs 5'3". I was fortunate my ins covered procedure. (I hv GHI) My PS removed 304g from one side and 340 from other side. I hope u hear good news soon from BCBS!! (:
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Top Heavy
September 8, 2014
Hi there, I just found your review! I am 5'1" and 110lbs and just turned 46. I went from a 30E/32DD (I could never find a 30E in the shops) down to a 32B. It was absolutely the best thing I've ever done. It's difficult to find reviews for smaller framed women on this site. You're welcome to have a look at mine. I haven't updated it for a while now - I need to do that - but I've posted before and after photos. Good luck!
Dlbf
September 8, 2014
Yes, I've found out that my band measurement is a bit uncommon. I think I have looked at your pics, but I'll definitely go take a look to make sure! It's hard to get a idea of what the results will looks like and how much tissue needs removing. Really hoping to hear from insurance this week! The dr didn't seem to optimistic that they would cover it due to the 250 he thought he would remove. It really stinks to be smaller in this case!! Lol I do not want to go through with this and end up a D!! Thanks!
UPDATED FROM Dlbf

Still waiting.....

DlbfSeptember 9, 2014
I called bc&bs federal yesterday to be told that all of my paperwork was received on the 4th..... Last Thursday. Ummmm, my consult was 2 months ago! I was quite unhappy to say the least! I called PS office, of course she was out for the day, left her a polite but to the point message. She called me today saying that she has no idea why they would've said they got everything last Thursday.... She said for some reason they've had trouble getting my pics. Email didn't send them so she has mailed them multiple times and today over nighted them. So they're are pics of my tatas floating around somewhere in the world! Lol she seems so sweet and honest but I'm quite frustrated! Hopefully I will get approved soon and this will all be a distant memory??
Couple of questions.....
I have a cruise scheduled for mid November. How much recovery time do you recommend before taking a trip like that . If I get approved I want it done ASAP, however I don't want to be so restricted on my trip either. I'm a hairstylist and taking a couple of weeks off in December is not a good option for me! That would push me to next year and having to meet a deductible.....
How long before you are able to be in water? On the trip I'd like to go snorkeling??
Have any of you had trouble with numbness in hands? If so did the reduction help?
Thanks in advance!

Replies (2)

Cree11
September 9, 2014
Yikes! I'm sure ur PS was being honest and hopefully all this will b approved and a very distant memory!!! As for ur recovery everyone is different. I'm about 4 wks post op and had a great easy recovery (so far) and I can't complain! U may want to check w ur PS regarding submerging in water I know that was a no no for a bit but u should really ask those ques to ur PS. My ps gave me a list of do's and don'ts preop so I was informed. As for the numbness in hands...yes I had that along with neck shoulder arm pain and it is gone! (: no more numbness or horrible neck/shoulder pains. Good luck to u!!! Talk to ur PS regarding ur questions. Ur PS will def have best answer for ur situation! (:
Dlbf
September 10, 2014
Thanks! I'm glad to hear the numbness went away! I really was shocked when he said it wasn't carpal tunnel. I think mine is caused from a combo of doing hair, boob weight, and my terrible posture. I'm hoping that I'll be approved and reduce these gals and see a difference in the back, neck, shoulder pain and hand numbness too! If I have to stay out of the water on the cruise I will, just really want it done!!
UPDATED FROM Dlbf

Update on the waiting

DlbfSeptember 11, 2014
My PS office called yesterday to tell me that the insurance received my pics FINALLY, and that it should take about 72 hrs for a answer (business days) so early next week.... I'm trying not to get too excited...... I'm going to be crushed if it's denied...... The waiting is terrible!

Replies (4)

Cree11
September 12, 2014
Ugh! The waiting is by far the most horrible part! I hope its news u wish to hear! Will u still move forward w surgery if they don't cover? I hope u go for it cuz it will b such a relief for u! Sending u lots of well wishes that u get this covered! (:
Dlbf
September 12, 2014
I'd love to go ahead with it. However that's a lot of money for me right now. I'd hate to spend it then regret spending it on myself. Or God forbid something happen and need it for something more important and not have it.....
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WENDY1956
September 13, 2014
You Don't have any Pics on here to tell - but My Surgery was on March 5th. They took off 660 grams from my Left Breast and 620 off of the Right. Make sure to take LOTS of Pics - for YOU Especially - so you will have them to go Back to - thru the whole healing Process. It's so Very Helpful.
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WENDY1956
September 13, 2014
ALSO ....... Make sure to Ask ....... if you are going to be Flying ... How LONG you need to wait - before doing so !
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