Topic: What are my rights in getting revisions to flap donor site?

Forum: Employment, Insurance, and Other Financial Issues — Employment, insurance, and financial concerns are common. Meet others here to discuss and for support.

Posted on: Jul 10, 2017 01:19PM - edited Jul 10, 2017 02:17PM by Ad197

Posted on: Jul 10, 2017 01:19PM - edited Jul 10, 2017 02:17PM by Ad197

Ad197 wrote:

I had bilateral Sgap. All went as planned with no complications according to my doctor. I am not happy with what my doctor did to me. I am worried that insurance will not pay to have my donor site revised anymore after I had stage 2 and I still have work that needs to be done. My insurance coordiator advised me to not go back to him and also told me that no other doctor would fix me. I can't live with the way I look. I don't know who to go to for more revisions. Do I have to live with my buttocks deformed? I am young and this has been a nightmare. Any advice greatly appreciated.


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Jul 12, 2017 11:32AM Ad197 wrote:

There is no DIEP surgeon within 50 miles. I checked with insurance and I will have to pay out of network fees. We can't do that. Even in network is too high. We planned on having this done in one year. We don't know what we are going to do. I pm' bdavis just now.

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Jul 12, 2017 11:58PM - edited Jul 12, 2017 11:58PM by Lula73

have you looked into dr Craigie or Dr Massey in Charleston, sc?

-Lula Dx 1/2017, DCIS/IDC, Right, 1cm, Stage IA, Grade 1, 0/2 nodes, ER+/PR+, HER2- Surgery 2/14/2017 Lymph node removal: Sentinel; Mastectomy: Left, Right; Prophylactic ovary removal; Reconstruction (left): DIEP flap; Reconstruction (right): DIEP flap Hormonal Therapy 3/3/2017 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery 11/1/2017 Prophylactic ovary removal Hormonal Therapy 1/3/2018 Femara (letrozole)
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Jul 13, 2017 03:42AM Ad197 wrote:

I was just looking at PRMA. I wonder if they could help. It looks like they do one side at a time, but they could help me with my revisions. I don't know which PRMA doctor does the most sgaps?

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Jul 18, 2017 05:40PM DiepGal wrote:

Hello Ad197. I would suggest reaching out to the patient liaison at PRMA, Brittany. She may be able to answer your question directly. May be worth it to shoot her an email. From a personal standpoint, I had a DIEP at PRMA and needed a lot of revision in my circumstance because of radiation I had 12 years previous to my DIEP. I was also a delayed DIEP. I am truly happy with my results. It was not an SGAP but I know they are excellent with revision issues of all kinds in breast reconstruction there. Hope this helps and I'm happy to answer further questions.

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Jul 19, 2017 12:13PM Ad197 wrote:

I called PRMA and they said any revisions to my buttocks can only be done by original doctor for insurance to pay. My buttock deformity is directly caused by the SGAP. I have seen women get their diep donor site revised by other doctors than the original one who did the diep. Did insurance pay for that or was it considered cosmetic Can I fight this? How?


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