What the heck, I am a failure
My insurance paid for both my TT and BR back in 03. I had my OB/GYN and my chiropractor write a letter of medical necessity, along with my own letter and between all 3 of them, it worked. You have to always use the word 'reconstruction' for some reason as I remember it. However, I know that a friend of mine tried getting a TT after losing so much after surgery and he wouldn't do it until she got close to goal. The reason is that if you do it too soon, your skin will hang again if you lose a lot after the TT or BL. So, if I were you, I'd work on getting close to goal first and then getting those letters done from doctors and I bet you will get approved! Good luck!
I had a breast reduction before I reached goal weight and it was a great thing. I immediately felt better, could sit up straight (I was a J cup even after losing 200 pounds), and everything was better. I am triangluar in shape--narrow shoulders to wide hip--so still have size differences between tops and pants. But it was so worth it.
The truth is no amount of plastic surgery will make all the signs of our obesity go away. No surgery will give you the "perfect" look that we idealize in our heads. Part of the process is to come to a reasonable expectation and then deal with the reality. Do I "love" the way I look? No, but considering where I was, it is a huge improvement. Are there bits of my body that embarrass me? Yes, but I'm still grateful to have a functioning body--and good clothes!
You might need to have the two sugeries done separately, maybe even years apart, but until we win the lottery, most of us just have to muddle through.
Good luck,
Sally