How to get by a plastics exclusion?

My insurance (Aetna-Chickering) will not cover my thigh lift due to the exclusion for gastric bypass in my insurance. They state even though it has been deemed medically necessary, they wont cover it because it is as a result of gastric bypass and is cosmetic, an excluded service. I have tried once and appealed and denied again. Any suggestions or am I sunk?

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