A Long Time Coming...- Longmont, CO

I am 40 years old, 5'6", 175 lbs, married for 10 years and have three children, all breast fed. I measure 36E, but I have squeezed into a 38 or 40 DDD minimizer bra for several years now. I have constant back, neck and shoulder pain. I didn't develop early, but by the end of high school I was spilling out of a C cup, and by the time I got married I was a DD. I have wanted a reduction for a long, long, time. My youngest is five, and my breasts never snapped back to a manageable size after the pregnancies and nursing.

I have been actively working on getting prepared for a BR for over a year now, as I worked through the hoops set by my health insurance to get this covered. My insurance is Cigna, and they have proven to be incredibly difficult to work with. I did two years of chiropractic care, several months of PT and recently underwent shoulder surgery - due in part to the stress of my bra strap over my AC joint. I submitted five letters of recommendation for this procedure (3 of them written by MDs) and my PS submitted the entire request (pictures, letters, outline of proposed surgical procedure) to my insurance on July 8th. It was denied the next day. Cigna did not believe there was enough evidence to warrant a BR, and that the PS was removing too little. My PS though 400cc on the L and 500cc on the R was appropriate. Cigna wants 600cc, each side. I was spitting mad. I wanted to appeal, so my PS resubmitted, reluctantly agreeing to the 600cc/each amount - just to see if Cigna would accept. Normally appeals can take up to 30 business days. Cigna went over that mark by a few weeks, because it took over a month before they admitted that the appeals department never received my file. My PS had to resubmit everything, and it was another two weeks before I was approved. I have nothing nice to say about Cigna. They were completely unprofessional, and this 600cc amount is a very aggressive amount to require - it is in excess of what the industry standard is for removal, based on my BMI (28.6) and height (5'6"). This 600cc amount is actually complicating the whole procedure. My breasts are not the same size, and by removing this much tissue, it could place me in danger of losing feeling or worse - my nipple on my smaller side.

I had my pre-op the day before yesterday, and that was when the serious concerns from my PS about the 600cc amount came about. When I went to the PS for my initial consultation back in June, I weighed 192 and had a BMI of 31.5. Since I have lost about 15 lbs since then, this made the whole situation a little bit more critical. Imagine...getting in trouble for losing weight!!!! I left the appointment with a decision to make: go forth with the surgery and follow the ridiculous dictates of my insurance company, and risk complications - and be unhappy with really small, unnatural-looking results in comparison to my frame, OR totally switch gears and make this an out-of-pocket ($7200) cosmetic procedure instead - and take off what is right for me. Talk about pressure!

I had never felt so devastated and conflicted! The surgery is a week away - the surgery I have been waiting YEARS for and fought so hard for, and now I get this unexpected curve ball. My husband and I went back and forth. I am so desperate to be done with the pain and discomfort that I was totally willing to accept the risks. My husband was not. He went pale when I said I could loose a nipple. He was disappointed that I could potentially end up with B cups. We looked at lots and lots of pictures - on this site and other surgeons, looking for what end result we could agree on. We found the ideal picture, and agreed that that was the goal - if he could achieve that by adhering to the insurance company's strict amount, great. If it meant we would fall short of that 600cc/breast amount and have to pay out-of-pocket, so be it. I can't let a bunch of idiotic number crunchers dictate what I end up looking like. It is my body.

I have been visiting this site for about a year now. It has been tremendously helpful to see what is in store for me from start to finish. It has really helped me prepare mentally for the changes and hardships that are to come. I am so grateful for all of the previous contributors who bared their soul and their bodies in the interest of building this supportive community.

I would like to offer my own advice... I have read many stories about women who go to their consultations with just a preferred size in mind. I would like to suggest that you think long and hard (before you go) about what changes you are really after. What is your desired profile? How wide? How high? What sort of physical activities do you see yourself doing in the future? When my husband and I were looking for that 'ideal picture', I was keeping all of that in mind. My ideal had to show the maximum amount of projection I was going to be comfortable with. I want to see my feet! The maximum width - I want to be able to swing my arms about and not have boobs in the way. I want them high and tight. I've had droopy boobs forever - I am so tired of boobs in my armpits when I sleep. I want MINIMUM bounce. I want to make running a part of my daily life in the future, so I want an appropriate size that won't get in the way and cause discomfort.

So I went BACK to the PS yesterday to have further conversation about what my decision was. When I showed him the ideal picture and we compared it to my photographs that were taken there at the office (a second set had to be taken to update my profile because of the weight loss). We talked at length about breast tissue density, fat deposits, projection, how the removal happens bit by bit during the surgery, how he pulls from the armpit forward, and how my new size would mesh with what I want vs. don't want. It pays to openly and explicitly communicate with your surgeon. He is feeling more confident that he can appease the insurance requirement, but we are both in agreement that, if at that point in time during the surgery that he is concerned about the risk of removing too much, he will stop, and sort it out (ie. fight like hell) with the insurance company after the fact. And, if in the end it has to be treated as a cosmetic procedure, so be it.

I am feeling very confident in my decisions. I've never waffled on whether this was the right thing to do. I worry a bit about losing sensation or God-forbid my nipple, but the risk is so worth it to me. I can't take the discomfort anymore.

I have a lot to do in preparation - get my Rxs and OTC meds, a couple of cheapie hook-in-front sports bras (chosen according to band size -36), and general around the house stuff - laundry and freeze some meals. My husband is working from home for about a week after my surgery, so I will be able to rest properly in those first critical days. I am thankful to keep busy, it will help the next six days go by fast!

It is the morning of surgery and I have a few more minutes before my mom comes to pick me up for the hour drive to the surgery center. I check in at 8 a.m., surgery begins at 9:15. My husband and kids are still in bed, they will all come to pick me up when it is okay to go home. I had an incredibly difficult time putting the kids to bed last night - especially hugging and kissing them goodnight. I am very emotional right now... I cried with my daughter (age 8).

The past couple days have been a whirlwind. The day to day activities did not let up, so I had to squeeze in my prep shopping, cleaning, laundry what have you, whenever I could. So I feel like I have very little mental processing time. My breasts have been very painful in the past couple of days. Shooting pains and they feel like they are on fire. Not temperature hot, just a burning sensation deep within. I've never felt that before. Maybe they know something's up?? Lol..

I am feeling excited but pretty scared. I am not looking forward to weeks of discomfort. But I am so ready to get this done. One look at my body this morning in the mirror after my shower, and I was on cloud 9, knowing that in a few short hours it will be all different. TODAY is the day I have been waiting for years and years. See you on the other side!

My surgery was yesterday morning and it lasted about 3.5 hours. My PS took 630g (1.39 lbs) from the right side and a whopping 818g (1.8 lbs) from the left side. So I guess there were no worries about not being able to meet the insurance company's requirement for 600g from each side!

I stayed in recovery for almost 4 hours. I guess I was moaning in pain quite a bit and so the nurse kept pushing painkiller through the IV, and that just kept me in a very drowsy state. My husband kept pushing me to take spoonfuls of crushed ice, and small nibbles of saltines. Since I was able to keep that down the nurse relented on the IV and let me take a strong dose of Vicodin. I was in and out of it all the way home and throughout the evening. I have a 10 day supply of antibiotics to take, which I also need to take some Florastor to help replenish the flora in my gut. I have an anti-nausea patch behind an ear, painkillers (Hydrocodone), stool softeners, and benedryl in case I react to anything.

I don't have drains, and the stitches are all internal and dissolvable. My PS taped all of the incisions and the tape needs stay on for two weeks. I was sent home with tons of gauze padding and a huge stretchy tube top with Velcro tabs to pull it tight. To say that I am uncomfortable is a huge understatement. What's left of my breasts is pushed up high with the padding wedged underneath and to the sides. I can't rest my arms at my sides right now. I am feeling the most pain from my incisions and my sides. It is tolerable when I am reclining, but whenever I get up the pain is just incredible. I think it is a combination of gravity, swelling and this ridiculous tube top that is cinched so tight I can barely breathe.

I did sleep sort of okay last night as I am still pretty drowsy, but my back is already killing me. I see the PS this afternoon, so I hope that he switches things around so that I can get *slightly* more comfortable.