Bye bye juggas!

Well here we are at the bye-bye juggas last final stage. After the appeal, my insurance overturned a denial for what I believe is called a mastodynia lipectomy. Basically it is a follow up surgery to remove excess tissue via lipo on the side trunk and top of each breast for a total removal for this second round 500 grams total in addition to the original BR. My scar tissue removal had not fully healed yet. I had some skin peeling and developed a rash under one of my breast. With the lipectomy they did a small incision on each side of my breast. There is a lot of bruising and swelling at this point. The reason for the lipectomy was to keep from having what is called "nipple death." I wasn't happy with my original nipple turn out on the right side, but that is something I have to live with. What is done is done. I have pads which soak up the expected drainage from the lipectomy. My doctor explained the draining will be for the next few days. I am to wear a tight fighting sport bra, a little different from the original recommendation. My dr. for this procedure was awesome. At the hospital she was at my bedside every step of the way, and I even saw her when I discharged when she came to the car to see me off. She called me the day after to check on me, an I have a post op appointment in a week. I am to keep my skin oiled to keep it from drying out and to massage along the scarring. BTW the new scarring from the last procedure is a little deeper along the side of my breasts than before, but because it was scar tissue removal it was explained it was necessary (I couldn't stand that little fold that looked like a vag under my breast that accumulated the most awful smell--gone now!) It was a long two year journey . . . I wouldn't trade it, heck no. I can actually throw on a tee and go, without my boobs dragging and flopping across my belly. I am healing once again, for the two follow up surgeries. I feel the whole journey was so worth it. I do regret having waited so late to get this done, but I still have time left to enjoy the benefit, so now I have to move on. Ladies, however you do it, make sure the doctor understands 100% what it is you want, what will fit with your body, and be patient. Be healthy, feel good about yourself, and lovely. I will update you in a few weeks to see the transition. Here are a few pix.

Oh where o'where have the little dogs gone! Well, here we are two years later, appeals with the insurance, and a new surgery date set up. (BTW my weight is another issue--not there yet lol!)

Anyway, I think I posted some information about after my original mammoplasty, and after two appeals, I won the appeal to have scar tissue and dog ears removed, as well as some revision. (The scar tissue under my breasts were overlapped and created the sensation of a lot of chafing, and carried a lot of odor, no matter how often I cleaned. And even though I am overweight, my breasts were still much larger than anticipated after the surgery, and I actually still had problems with my shoulders. Also, even though I am overweight, it was explained to me years ago that I have a small frame, so the weight of my breasts will feel even heavier--this is why my original surgeon said a small C would be best--never happened. After the surgery, I am more like a larger D.) After the approval by my insurance, I was referred out to an independent plastic surgeon, office of Dr. Joseph Ku and Dr. Natalie Driessen, a well known five star office for various surgical enhancement procedures. I chose Dr. Driessen over Dr. Ku, namely because she is a woman who seemed to understand my choice to have a follow up surgery to remove more tissue (by liposuction), as I truly felt my breasts had more "meat" left than it should have from the original surgery. The reason why lipsuction was chosen is that it is much safer with a follow up revision, especially to bypass the risk of "nipple death." Remember, each case is different. Anyhow, the plan was to remove apx an additional 500 grams, dog ear and scar tissue removal. The surgery date was set for 12/15/15. Well, lo and behold, a couple days before the surgery I found out the insurance denied the part of the surgery to do the additional mammoplasty by liposuction only. I immediately filed an expedited appeal by phone. It was denied as an expedited and promoted as a regular appeal! It was denied, even after Dr. Driessen gave a full explanation as to why the follow up mammoplasty by lipo was necessary.

After that I met with Dr. Driessen for a pre op. She gave me the opportunity to waive the surgery for the dog ear and scar tissue removal, pending the outcome of the appeal. I decided to go ahead with the dog ear and scar tissue removal, since I had already gone through the ritual with taking off work--it's not that easy to take off my job, so it was a natural to just go ahead with the plan--besides, what if the appeal was denied, then I would be stuck with taking off more time yada yada yada. Boom there it is. So, I went ahead with the dog ear and scar tissue removal and went on about my business. On the day of the surgery Dr. Driessen asked me, if the appeal is accepted, would I want the revision, and of course I said yes, and I want the surgery to be expedited (I believed it would be denied anyways.) The surgery was quick, and I am on my way to healing. Even though the surgeon had to extend my prior scars a bit, the scars are smooth, and the dog ears are gone! All I have to do now is to add cellular tape and massage at least three times a day.

Guess what, on 1/02/16 I received a letter dated 12/31/15 from my health plan, and they said the appeal denial will be reversed and the mammoplasty by liposuction is approved! Yes! I immediately informed the surgeon, and wrote to her to ask that the surgery be put on calendar as soon as possible, so that I can get the time off asap. I went back to work yesterday, but I also informed my employer that a date is upcoming very soon just to give them the heads up. So right now, I am waiting to get the surgery date. I have already done my required updated mammograms, labs etc., so I am ready to go! It should not be as complicated as the original and the recovery time should not be as long.

So ladies, many times you have to advocate, advocate, advocate. Hang in there. Don't accept no for an answer, especially if you have a lot on your side. Fortunately, my doctors also advocated, and that certainly helped. It has taken a lot of time and effort, but it will be well worth it. I have a few updated photos for you.

Well this was all part of the appeal for a breast reduction repair/revision. There were about 50-60 photos altogether sent to my insurance. The doctor asked for a revision coverage for scarring--guess what? It was denied. I followed suit with an extensive letter showing from day 1 to December, and the fact that I still had issues, namely breasts still causing problems with grooves in the shoulder, scarring and folding "gathering" under the breasts, unusual odors, one breast higher than the other, a peek-a-boo nipple that I was told would eventually come out of hiding (but never did), doggie ears . . . ooops your bad. The target per agreement was a small C, and final was a DD. I started out with an unknown about a humungous G-H maybe bigger. After I sent the appeal, I won the authorization just recently on 12/18/14 with a final approval letter just received today. I can also have a second opinion outside my insurance. It was a long wait ladies (and men lol), but worth it. Like I said, I strived for perfection, did not expect it, but not this.

Don't get me wrong, I am happy, but I want to be happier, and I think it was to my benefit to have corrections where due. So, stay in touch with your results. Be patient. If it works for you great! If there is something missing--or just doesn't seem right, pursue it.