Question:
Approved for breast reduction w/one surgeon but not with other

Okay people my question recenly I went to see aplastic surgeon whose breast reduction was denied by my insurance company for too little tissue removed. Now this place is a really ritzy plastic surgery office. The surgeon told me all i needed was a breast lift because I was just mostly skin. However, I heard from a plastic surgeon today who told me that I was approved by my insurance company for a reduction w 1650 or 1750 grams of total being removed. I was totall shocked. I was thinking this other doctor just told me that if he took the amount of tissue off that the insurance company required I would like I had a masectomy-The surgeon who got the br approved also told me that the abdominoplasty was approved also but that he only does that w. additional surgery that tightens the muscle and lifts up the pubic area as well but that would be an additional 4000 dollars and that is way that he does it that he does it totally not just the removal of the skin the way the insurance company wants things. I don;t really have a prefernce for either surgeons persoanlity they both seemed kinda rushed, but whatever. Also -sorry this is long I was told if I go through with this reduction I wouldn't see the plastic surgeon again until the day of surgery where at the time they would measure my shoulders and waist in relation to see what size breasts would look good with my shoulders. What would u guys do? I want a better idea of what I'm going to come up looking like-lately I'm starting to feel like I just want my breasts to sit up and be smaller instead of hanging down to my knees. I'm 24 42DD from a 48DDD/Thanks for your help    — TotallyTori (posted on February 23, 2005)

February 23, 2005
1650 to 1750 grams PER BREAST??? That seems like a LOT of tissue to be removing. The normal amount to get the breast reduction covered is about 500 grams per breast. Did they tell you what your breast size would be after surgery? I think I would ask a LOT more questions of the surgeon who got the approval. You might end up with basically NO breasts by the time there done. I just had a breast lift a month ago and he only removed excess skin - no breast tissue. I was a 36D on the day of surgery (started out at 42DD before I had WLS). I bought some bras a couple of days post-op and bought 36B's. I just got measured and they measured me at a 36C to a small 36D. I would ask how much excess skin they would be removing and what bra size that would leave you at.
   — Patty H.

February 23, 2005
I think I would seek out a third opinion. I've never heard of a plastic surgeon who wanted to put a patient through so much surgery unless it was at the patient's request. I have a friend whose had several plastic surgeries now since she had the silicon ring done, but she had her surgeries broken down to where it wouldn't be so extensive. First she had to have a hysterectomy, so she had her panniculectomy done at the same time. She also opted to have her legs done. Several months later, she had a breast lift and her arms done. She also had her legs done a little bit more at that time. But it just seems like to me having the breasts and the tummy all done at the same time would be rather extreme and painful to go through all at the same time. Ouch!!!
   — SnowWhiteDove459

February 23, 2005
the first sounds more honest. The second hmmmm first 1650 is ALOT the min for a breast reduction is 400 ususally - I had aetna and they 'inflate' their amounta alot.. as far as the abdominoplasty - my surgeon did the pubis lift for free and he didnt force the muscle unless you wanted to pay for them, then it was 1000. I would do a third opion or go back to the first.
   — star .

February 23, 2005
I would definately get a third opinion. Unless the 2nd surgeon is planning on getting creative with the insurance company on how much tissue he removes that is A LOT of tissue. One thing to consider... if the third surgeon says 800 per breast is too much you can go with the 2nd surgeon and if your breast end up too small you can always go with an implant at a later date. I know that sounds odd but the truth is you can get implants at a MUCH smaller cost to you than a reduction. As for the tt the second surgeon is right...you probably wouldn't be happy with just skin removal..
   — SJP

February 23, 2005
lots of people do breasts and tummy tuck at the same time. My insurance paid for skin removal ie a panniculectomy, I also had muscles tightened and a belt lipectomy, and arm lift. I would recommend also the pubic area lift, and ask for it to be made very flat. Mine came out a little puffy looking and I am looking to get it revised. I am having a breast lift and augmentation, and a thigh lift, and lipo on my lower back, I don't yor docs prices seem out of line. Where I would be concerned is that you wouldn't see the surgeon again until surgery day. Maybe my doc was babying me, but I was in his office 4 times preop to discuss everything, get my questions answered, he wanted to be sure I was realistic in my expectations, and go over the informed consents in great detail so I would understand all risks and alternatives. As far as their differing opinions, well no 2 doctors ever seem to see everything the same way. They are each telling you what they think. What is important is what you think and how you feel, You are the one who has to live inside your body and you must be comfortable going into this. A couple weeks preop I came into the office and he took a marker and marked where the incisions would be and how much skin he would remove and it gave me a great picture as to how I would look. As far as the breasts, when I asked him how does he decide size, he said " I don't decide, you do" You are paying him a lot of money and you deserve to be treated very well.
   — **willow**

February 23, 2005
Original Poster-the 1650 is total I believe it is 800 or so from each breasts. I think i am going to schedule a second consult with this physician.
   — TotallyTori