Dogears revision covered by insurance?

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Inchbyinch
Inchbyinch Member Posts: 4
edited December 2016 in Living Without Reconstruction After a Mastectomy

Since my BMX with no reconstruction in 2013 (recurrence after 6 years post treatment), my "dog ears" are bugging me, both aesthetically and comfort wise. I currently have big time fat necrosis in in cancer related side (radiated in 2007). So I am having my consult with PS to remove necrosis and at the same time remove the dogears. When I had my BMX, I had fat injected under the skin to try to make a small mound look. I am going to get that all sucked out at the same time. It looks weird because the previously radiated side with the necrosis is all gathered up, while the prophylactic side is droopy fat. (Already have plenty of, thank you very much). Here's my questions: 1) Of those of you who have had dogear revision, was it paid for by insurance? 2) Also, any advice on when I ask PS to remove the fat under the skin (I would like a flat look)? Should I still spare the skin or have everything I can removed? I want it to be easier to feel possible tumors in chest wall easily but want to avoid being concave. Thanks

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  • GmaFoley
    GmaFoley Member Posts: 7,091
    edited April 2015

    I haven't had a mastectomy but I had a breast reduction and reconstruction 4 months ago. It was necessary as my breasts were too large and causing pain after radiation. I have dog ears and the doc set up an appt to have them removed. After he talked to the insurance and used the words "Breast Cancer" and "reconstruction" they ok'd it.

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  • glennie19
    glennie19 Member Posts: 6,398
    edited April 2015


    Tell the PS that you want your chest to be flat like a 10 year old boy,,,, if that's what you want.  But yes,,, insurance is supposed to cover any reconstruction after breast cancer and that includes removing dog ears.

    I think over on  www.breastfree.org   you can find pictures of those who went flat,,, if you see what you like,, you could show those pics to the PS.

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  • Inchbyinch
    Inchbyinch Member Posts: 4
    edited April 2015

    Thanks Glennie19. I remember on another thread the mention of looking like a 10 year old boy. I'm ready for that now. Two issues with that: 1) I also read on that thread that some women were having trouble with it feeling too tight/taught. Is it possible to be too flat and then ending up with irreversible tightness? 2) 10 year old boy is great If you have a tummy of a 10 year old boy. I do not feel self conscious about no reconstruction, but I have felt really self-conscious about my belly. I try to tell myself I'm alive with a recurrence and not to care, but it's easier said than done

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  • GmaFoley
    GmaFoley Member Posts: 7,091
    edited April 2015

    After my breast reduction - I felt very tight - it was unbearable without pain meds. But I'm 4 months out and everything is softening up and feeling lots better. I'm thinking that would be the same tightness as a MX?

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  • dtorrent
    dtorrent Member Posts: 17
    edited April 2015

    I had a BMX with no reconstruction 2 weeks ago. Right before surgery, I re-emphasized to my surgeon that I was not going to decide later to do reconstruction. I am 42 and youthful (in my mind at least) and athletic. She did a great job, I am indeed flat like a 10 year old boy. But I can attest, it IS tight. But the stretching exercises REALLY help. It gets a little better every day. Just sitting up really straight and arching your back provides a nice gentle stretch. I am hoping after a while it will be unnoticeable.

    Good luck!

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  • Erica3681
    Erica3681 Member Posts: 1,916
    edited April 2015

    dtorrent, at only two weeks out, I'm not surprised you're still tight. I agree that the stretching exercises will help. And if you can find a physical therapist who works with breast cancer patients, such a person can often be very helpful in making sure you regain your full range of motion.

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  • Inchbyinch
    Inchbyinch Member Posts: 4
    edited April 2015

    Thanks Everyone. Saw the new PS yesterday (original one moved practices out side my insurance network) I was so glad that I had asked you all. I felt more ready. He asked if I was sure that I wasn't going to want reconstruction down the line. I said that I didn't want it 2 years ago and I've had more time to think about it. And may I please have the "10 year old boy special"? So the flabby skin and "bra rolls" (I liked that's what he called them) are coming off

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  • NormaJean65
    NormaJean65 Member Posts: 234
    edited December 2016

    Is anyone here old enough to have Medicare for your insurance and do you know if they pay to fix the "dog ears" ? I had two separate mastectomies by the same surgeon and left with one side looking completely different from the other plus the dog ears.

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  • Bearhitch
    Bearhitch Member Posts: 40
    edited December 2016

    I was going to add in here that i was told it WOULD be covered by ours because it was a revision of the original surgery. That said - I have a question... so I have dog ears too and plan to either fix them or I was thinking about seeing what fat injected into mounds would do to maybe help offset some issues I've had.... specifically that after my surgery I gained a lot of weight and now look pregnant - all of the time. I was hoping it would maybe soften that - but you are having that taken out. Did it not look right or may I ask, with that what your thoughts are?

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  • NormaJean65
    NormaJean65 Member Posts: 234
    edited December 2016

    Bearhitch.......the original surgeries were covered under my DH employer insurance. Now Medicare is our primary w/ Tricare for Life (military) is our supplement. I guess I will have to suck it up & make a phone call to Medicare or given my age forget about worrying about the rolls of fat that shows when I wear a bra. I don't know if you have a BMX or UMX or a lumpectomy. I guess it's a question to ask a PS.

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  • MinusTwo
    MinusTwo Member Posts: 16,634
    edited December 2016

    I believe revisions are covered by law.

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  • GmaFoley
    GmaFoley Member Posts: 7,091
    edited December 2016

    I'm not 65 yet but even my little insurance covered my revisions. You do have to go through a preapproval .

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  • NormaJean65
    NormaJean65 Member Posts: 234
    edited December 2016

    Hey MinusTwo & GmaFoley..........we are talking about the Federal Gov. that makes up rules as they see fit. I do know about the law you speak about.

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  • MinusTwo
    MinusTwo Member Posts: 16,634
    edited December 2016

    NormaJean - this was several years ago and has been posted on this site a number of times. The women I've heard of who needed revisions have been able to get the cost covered, although the insurance companies may hassle them first.

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