Breast??s again- calculating BMI/BSA in post op?
I have appt with PS this week and I intend to ask him also, but...
Is there a different formula used in post op/massive wl patients to calculate BMI/BSA considering excess skin tissue?
My story: 4+ years post op, started 298 now 150. Had panni/TT 1st year due to large hernia repair. removed 7lb skin tissue. I have done some research on what my insurance covers etc. I know that the policy states I must lose a certain amount of tissue per breast...based on my BSA (body surface area). I have questions about how this and BMIs are determined in post op patients considering the excess skin and adipose (skin fat) tissues. I know that if I did not have excess tissue I would weigh less thereby reducing my BMI and BSA. Is there a formula that is used. Even with TT, I still have lax skin and 1/2 inch fat layer but when you feel my abdomen the muscles are rock and I even have ridges (6 pack). I do exercise and work out regularly but the skin and fat layer do not decrease. I am not sure that I want to go through removal of all of it, but I think that it should be considered when calculating the numbers. I feel that this also contributes to my high estrogen levels...
I Wear compressing bra (only fill B cup) all the time except for shower. Have pain through shoulders/neck, numbness in arms and hands, grooves in shoulders, lines wrinkle marks in breasts etc. No rash though. Now have been diagnosed with fibrocystic disease (high estrogen?) and non cyclical breast pain. Common sense tells me wearing the bra is causing aggrivation in the fibrocystic disease because continuous compression is causing blockages in normal drainage etc ( hard lumps and patho discharges? biopsy benign). At the same time if I try to go bra free have pain through peck muscles (upper breast area) etc from weight of skin, sag (Grade III severe ptosis). Not to mention that nipples protruding in waist line are not very attractive...Totally different type of love handles...lol. Would like to seek medically necessary reduction/lift but since there is not much fat tissue am afraid I will not qualify for minimum weight removal. Having been obese since childhood, my breasts were always partially supported by my belly. There is minimal fat tissue in breast (mammo images almost white) no structure in the ligaments that are supposed to hold the breast to the chest so breast tissue must be reattached (or removed). I joke that if it wasn't for the skin sacks, then my breasts would slide to my pubic area... (might make sex interesting???) I am fearful with the fibrocystic disease that rearranging existing breast tissue and reattaching it will cause more lumps and pain? (although not medically proven...it seems partially caused by failure of lymphatic system drainage). I have had pain in the breast that was biopsied which has been explained by the rearranging of tissue to remove the duct. I am leary about implants because, yes having a nice set of girls for once in my life would be nice, but at the same time I am not looking so much for how they look as for comfort...not to mention any complications... Also since I do have problems with the weight I am afraid that the weight of implants would have the same effect. I cannot find any information this because usually a lift/BA is cosmetic and doesnt consider pain etc.
I am appreciative of any information, I am waiting to see what the PS says... crossing my fingers that I will get lucky. Saying my prayers... But at the same time wanting to get prepared for battle if necessary.
Is there a different formula used in post op/massive wl patients to calculate BMI/BSA considering excess skin tissue?
My story: 4+ years post op, started 298 now 150. Had panni/TT 1st year due to large hernia repair. removed 7lb skin tissue. I have done some research on what my insurance covers etc. I know that the policy states I must lose a certain amount of tissue per breast...based on my BSA (body surface area). I have questions about how this and BMIs are determined in post op patients considering the excess skin and adipose (skin fat) tissues. I know that if I did not have excess tissue I would weigh less thereby reducing my BMI and BSA. Is there a formula that is used. Even with TT, I still have lax skin and 1/2 inch fat layer but when you feel my abdomen the muscles are rock and I even have ridges (6 pack). I do exercise and work out regularly but the skin and fat layer do not decrease. I am not sure that I want to go through removal of all of it, but I think that it should be considered when calculating the numbers. I feel that this also contributes to my high estrogen levels...
I Wear compressing bra (only fill B cup) all the time except for shower. Have pain through shoulders/neck, numbness in arms and hands, grooves in shoulders, lines wrinkle marks in breasts etc. No rash though. Now have been diagnosed with fibrocystic disease (high estrogen?) and non cyclical breast pain. Common sense tells me wearing the bra is causing aggrivation in the fibrocystic disease because continuous compression is causing blockages in normal drainage etc ( hard lumps and patho discharges? biopsy benign). At the same time if I try to go bra free have pain through peck muscles (upper breast area) etc from weight of skin, sag (Grade III severe ptosis). Not to mention that nipples protruding in waist line are not very attractive...Totally different type of love handles...lol. Would like to seek medically necessary reduction/lift but since there is not much fat tissue am afraid I will not qualify for minimum weight removal. Having been obese since childhood, my breasts were always partially supported by my belly. There is minimal fat tissue in breast (mammo images almost white) no structure in the ligaments that are supposed to hold the breast to the chest so breast tissue must be reattached (or removed). I joke that if it wasn't for the skin sacks, then my breasts would slide to my pubic area... (might make sex interesting???) I am fearful with the fibrocystic disease that rearranging existing breast tissue and reattaching it will cause more lumps and pain? (although not medically proven...it seems partially caused by failure of lymphatic system drainage). I have had pain in the breast that was biopsied which has been explained by the rearranging of tissue to remove the duct. I am leary about implants because, yes having a nice set of girls for once in my life would be nice, but at the same time I am not looking so much for how they look as for comfort...not to mention any complications... Also since I do have problems with the weight I am afraid that the weight of implants would have the same effect. I cannot find any information this because usually a lift/BA is cosmetic and doesnt consider pain etc.
I am appreciative of any information, I am waiting to see what the PS says... crossing my fingers that I will get lucky. Saying my prayers... But at the same time wanting to get prepared for battle if necessary.
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