Need advice please

Hello there! I am 9 1/2 months post-op and down 137.5 pounds. I have my plastic surgery consult tomorrow. I have all my photos ready - front view, side view, back and thighs, and close ups of my rashes and boils. I have a letter from my PCP and my gastric bypass surgeon stating it's a medical necessity that I have plastic surgery. Do I write a letter to bring with me also or do I do that at a later date if I get denied? Is the first stage of approval left in the hands of doctors? Thanks!!!!!!!!!

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