livvsmum

I put in approval for both panni+abdominoplasty and a brachioplasty at the same time. The TT was approved and done, but the Brachioplasty was denied. They did the peer to peer review and I don't think anything came of it. I think at this point I have to write an appeal letter. Do you all have any recommendations or tips for getting appeals approved?

I put in approval for both panni+abdominoplasty and a brachioplasty at the same time. The TT was approved and done, but the Brachioplasty was denied. They did the peer to peer review and I don't think anything came of it. I think at this point I have to write an appeal letter. Do you all have any recommendations or tips for getting appeals approved?

It all happened in such a rush.....I got all my paperwork and medical records together, had my consultation, got my approval days later, and surgery the next week. I feel like I didn't have enough time to prepare. I was NOT prepared for how difficult the recovery would be. I only took 2 weeks off work and I need another week for sure. Also the drainage tubes. Oh. My. Gosh. So uncomfortable and painful coming out. OUCH! And then....um.....the girl parts are a bit differently placed than they used to be. THAT was a little bit of a surprise. I'm 2.5 weeks out from surgery, and the first 2 weeks for super rough. I'm feeling better every day now. I do have a couple questions for those who have done this. I have a very large bump on the the very very end of my incision - like on my hip bone - maybe from the internal stitches. Does this go away on it's own? What the heck is it? Help?

Congrats on the surgery. I hear you on not taking off enough time. I had a panniculectomy + abdominoplasty on 4/29 and took off 2.5 works from work. There is NO WAY I will be ready to go back. It was the most painful thing ever. I will take another work because my healing is the most important thing to me. Good luck in your healing! I'm jealous too! I put in for approval for a brachioplasty at the same time as my pann+ ab and the tummy was approved but the arms were denied. Random question, did you have drainage tubes for the brachioplasty?

I think everyone has a "oh my gosh what did I sign up for" kind of moment. Mine was about 2 weeks from surgery .I can tell you though, that after that initial week or so recover I have not for one moment regretted this surgery. It has made me experience so many more things with my kids and husband that I never could have done before. If you are freaking out I would encourage you to check out my blog (linked in my signature). I documented my journey from my very first pre-op appointment until today (20 months post op and recovering from my insurance-covered tummy tuck). And honestly, looking back, after doing both the sleeve and the panni+tummy tuck, the sleeve was a way easier recovery and much easier as far as actual surgery. It's easy to be scared by the "what if's" and the stories of surgeries gone wrong. I just thought I would offer you my blog as an option for a success story with a happy ending :-)

My goal for weight loss was 150 which would have been 138 pounds lost. My dream goal was 125, which I just recently reached and passed (by just a pound, but I'll take it....lol). So that puts me at 154 pounds lost. If you stick to the plan you will lose what you need to lose. At a certain point your body kind of settles into where it should be. I'm not sure if that answers your question.

Wearing my first bikini in my life this summer after losing 150+ pounds and having completed my panni & abdominplasty. I feel like a literally new person!!!!

You are doing well so far! I will tell you , though, that when I hit around 7 months, things seemed to change a bit and the "magic of the sleeve' seemed to go away and it became more good old fashioned work, just like before, but now I had this awesome "tool" to help me. One huge factor for me was counseling weekly with an eating disorder therapist. I started at 7 months post op, and now I'm 20 months post op and I have gone weekly since then. I know for a fact I woulnd't have been successful without working through the emotional stuff. BUt, to answer your specific questions: are you at goal? YES. My first "realistic goal was 150. My "dream goal" was 125. I've reached both. If so how long did it take you? I was at my first goal by 10 months post op. I just now (2o months post op reached my "dream goal" How much weight were you looking into loosing?I hoped to lose 100 pounds, I've lost 155. Hows your mental state? Right now I'm stronger every day, but like I said above I've done A LOT of work on the emotional side of eating. I wouldn't not be at my "dream goal" without all of the hard work that I've done emotionally through therapy. If you haven't looked into it, I highly recommend it. You can read more about my whole journey in my blog if you want (in my signature)

I didn't read all posts so I'm not sure if it's been said, but aside from all the usuals, I recommend ear buds and your music. I was supposed to have a private room but ended up with a shared room and the music and earbuds were the ONLY way I got any sleep with the other person in the room. Even if you have a private room it will block out the hospital sounds.

Congratulations!!!! Hope your infection clears up soon! I've followed your story for so long I feel like I know you... Our stories are quite similar and I feel like you're always one step ahead of me so I can look to you for what's to come, LOL! Doing my marathon in 9 days (so sorry yours got temporarily derailed) and then my plastics are scheduled for June 11th! Awww! Thank you! I'm SO jealous of your marathon. It was either do this surgery now or wait until July which would interfere with our vacation and that was not happening. We're doing the same just in reverse order. :-) GOOD LUCK at your marathon!!!! That is awesome!

Hi all - thought I would check back in now that I'm on the other side. :-) It's definitely been a more painful recovery than I thought. The drainage tubes were really painful when they were in and umm.......yeah......not fun coming out. I developed an infection in my incision and am on bed rest for a while, but otherwise, my energy level is picking up and the TT and panni themselves look great. I'm excited to finish healing and get back to real life. :-) I'm off of pain meds because I had a bad reaction to them and ended up in the ER. Today is actually only the 2nd day that I've been in yoga pants and out of a night gown. lol. I'm glad it's over. I was not prepared for the level of pain to expect and the tubes and how uncomfortable they would be (in and coming out). But I feel like I'm on the upswing now. I took an extra week off work because of the infection and set backs, but I should be back to normally hopefully soon! I just keep thinking "by Memorial Day I'll feel so much better!!".. Pick a day in the future and focus on it :-)

It was much more simple than I thought it would be. I called my insurance company with the codes for the abdominoplasty and panniculectomy and asked if my policy had a rider that covered them. They gave me a copy of it, I read the requirements, and once I met them all, I submitted it for approval. I got my approval back within days and my surgery was scheduled the next week. There were only 3 requirements 1. you had to be 18 months post op, 2. you have to have documented 3 months of trying other treatments with your PCP, 3. submit photographs. I also submitted a request for a brachioplasty (arm lift) and it was denied, so I'm in the process of appealing that.

Hi all - thought I would check back in now that I'm on the other side. :-) It's definitely been a more painful recovery than I thought. The drainage tubes were really painful when they were in and umm.......yeah......not fun coming out. I developed an infection in my incision and am on bed rest for a while, but otherwise, my energy level is picking up and the TT and panni themselves look great. I'm excited to finish healing and get back to real life. :-)

128.2 for me. I'll take it, all things considered. Still recovering from panniculectmy & abdominoplasty & it's been a difficult recovery.

I'm going to carry over my weigh from last week for this week's weigh in. I had a panniculectomy and abdominoplasty this week and am probably full of iv fluids. I'm not ready to weigh myself,so I'm sitting this week out. :-)

127.4 - Very happy about that after a gain last week.

So I was lucky enough to have my insurance approve my panniculectmy & abdominoplasty and it is scheduled for this week. I'm thinking I'll need some nightgowns since I probably won't want to be wearing even yoga pants at first. For those who have had this surgery, or have planned for it, do you have any tips? Anything else I should get, what to expect, etc. Any feedback is appreciated !!

So I was lucky enough to have my insurance approve my panniculectmy & abdominoplasty and it is scheduled for this week. I'm thinking I'll need some nightgowns since I probably won't want to be wearing even yoga pants at first. For those who have had this surgery, or have planned for it, do you have any tips? Anything else I should get, what to expect, etc. Any feedback is appreciated !!

Sorry I'm late weighing in. I think this may be the only time (or one of few) I've had to post a gain & it kinda sucks. +1.4 pounds this week. That makes my weigh-in 131.4 for this week. Oh well......

It depends on the type of work. I teach college, so some desk, some up and around. I took 2 weeks off, but really could have used another week off in retrospect. I really didn't feel fully "myself" as far as energy until about 6-8 weeks.

You just have to contact your insurance company and find out if they have the rider on the policy that allows for reconstructive surgery. Before doing that, though, call your surgeon and get the "codes" for the panniculectomy and the abdominoplasty, because the insurance company will need the codes to tell you if if is covered. If so, ask them for a copy of the specfic rider. This will spell out exactly what is needed for you to be approved. For me it was (1) at least 18 months post op and maintaining a steady weight, (2) medical documentation that you've tried other medical treatments for the problems the excess skin is causing you and they haven't worked, and (3) photos.

I have had people ask me if the weight loss was "on purpose" implying, are you terminally ill or something. So I think it can just be an adjustment for people who are used to seeing us very overweight to see us thin in a short amount of time. Especially confusing if they don't know about the surgery, which most of my co-workers don't either. I will say that if you are emotionally healthy and don't have a history with eating disorders, that your body weight should find it's "happy place" or resting place eventually where everything kind of evens out. So while we have ideal numbers in mind, it may not be where our body wants to be. But I don't think - if you have resumed the "new normal" post-bariatric diet and arent' living on liquids and Protein shakes that you would ever be in danger of losing "too much weight." I will say, though, that if you have a history of an eating disorder, this surgery can most certain trigger that. So in that respect, the surgery could be a contributing factor to an ugly old demon resurfacing. But if that's not something you ever struggled with, then I wouldn't worry about it. :-)

Thanks for the feedback. You're right I should focus on the positive and that I was approved for both. It would have been a bummer if I was just approved for the panni. Also helpful info on the recovery, so thanks! I'll have to look into how much an arm lift is out of pocket.

I'm currently 19 months post op. So I heard back yesterday from the surgeon that my panniculectomy AND abdominoplasty was approved by my insurance as medically necessary and covered. The surgeon said usually they just approve the panni, but that not many approve the abdominoplasty, which is your typical tummy tuck. He will remove the excess skin, but also tighten everything up, fix the sides up a bit, and basically build me a new belly button. It is horizontal, so hip-to-hip, and the recovery is said to be pretty rough. So the reason I'm only 1/2 approved and 1/2 excited is that my brachioplasty or arm lift was not approved, even though I have the medical documentation of the same issues occurring with the skin on my arms. So, they will send me a denial letter and it will have the appeal process. I will definitely appeal. My date for my tummy tuck right now is May 8, but I may push it forward to the beginning of June for a variety of reasons including that I might hear back on my appeal by then & I would much rather have both done at the same time. Sigh. I know I should be thrilled that I was approved for the panni and tummy tuck, but I can't deny that I'm a little bummed about the arm lift. Anyone have any words of advice on getting appeals approved? I have never had to appeal because my sleeve surgery was approved, and now the tummy tuck, but I definitely want to appeal the arm lift. Any tips would be greatly appreciated. :-)

So, I have Highmark BC/BS and my policy has the bariatric and reconstructive surgery riders, so I just found out I was approved for both a panniculectomy and abdominoplasty, which is AWESOME!!! But they denied my request for the brachioplasty, and I have medical documentation of the same issues on my arms as on my stomach. The stomach was approved but not the arms. The surgeon's office said I would receive my denial letter for the arm lift and it would include an appeal process. I will definitely appeal. I'm just wondering if anyone has had any success with appealing for a brachioplasty or really appealing a denial for anything. Any tips would be greatly appreciated.