9 years post op, hoping for facial reconstruction surgery

[CABindi]

Allo!  Allo!!  Am new to this, but here goes.  9 years ago, my AN was on the left side.  It was such in size that I had to have the hearing nerve cut and my balance and facial nerves very stretched.  I can live with the balance glitch every now and then, but am tired of scaring little people with my droopy face and the lower eyelid actually showing its insides.  I would like to get facial reconstruction surgery (brow lift, eye tuck, and mid-face tuck on the left side, and also a gold weight put into the upper eyelid), with a wish list surgery that would take a nerve from my calf that would stretch across my face (under the skin).  This nerve would connect my right side facial nerve to a muscle that would come from either my groin or underarm so that I would actually have a full smile again, rather than the lopsiided one I have now.  I have been told by my insurance company, BlueCross/BlueShield, that they do not make predeterminations on the medical necessity of a surgery.  They will however consider it after the surgery when the surgeon's office submits a letter and my medical record.  I'm wondering:  1) has anyone been through this surgery, and 2) has anyone ever been put through the wringer with an insurance company, but found it was deemed medically necessary??  I'm sure this is an expensive surgery and do not want to lose my house.  All BC/BS could give me was its website to research the Providers Library, medical policy.  (They did tell me at least that this was a surgery that would/could be reviewed and did not consider it "not at all covered".)  And to add to my stress, my husband has a chance to get into a medical flex plan, but needs to know by this Friday how much he wants deducted from his paycheck for next year.  Next time to sign up would be the following December of 2007.
               Thanks in advance - Cathy in IL

[nancyann]

Hi Cathy, Jeez, you've been living a long time with the awful symptoms of facial paralysis.

The gold weight, & lateral tarsal strip (for the lower lid to be pulled tighter) should be covered because damage can be caused to the cornea without it - I had these procedures done.

As far as the facial reanimation, I don't know if it's covered.   I may need the hypoglossal anastamosis in January, & that should be covered also (I have Cigna Ins.), especially if there are 'swallowing issues.'   Not sure about the other procedures.

After the hypolossal, I'll also be looking into further facial reanimation, I have a feeling the good ol' ins. company would see that as 'cosmetic'.   
During my internet prowling, I came across a Dr. Michael Sachs in New York whose website has some great before & after pictures of facial reanimation.  I've heard Dr. Azizzadeh also does facial reanimation (California - he did Mary Jo Buttafucco's reconstruction).

Best of luck if you stay with BC/BS  (know what the BS stands for? lol)      Nancy

PS:  I remember reading Pattibobatti  had facial reanimation done by Dr. Patrick Byrne at John Hopkins in Baltimore this summer, she was happy, but I haven't seen her log in lately.

[Raydean]

Thought i'd jump in and add that most of the time Doctors/Hospitals  will pre approve all procedures to make sure that they will be paid, or at least that's my guess.

Most of the procedures that you mention are covered, or at least should be.  It may require alittle work on your Doctor's part.  There are medical reason why these surgeries are needed, this is not done for cosmetic reasons.   Your treating Doctor will be able to documen the medical necessity and show pictures  that will show the need.  One time on the eye tuck my husband was denied coverage, we resubmitted with picture and it was approved.  Gold weight, hypoglossal nerve jump, 2 eye tucks.
all covered under BC.  Talk to your Doctor.  i am sure that he/she will assist you in amy way possible.

Thinking about you
Raydean

[nancyann]

Hi  Raydean:

You think insurance companies would pay for the facial reanimation procedures like brow lift, muscle transfer??  That would be great if they do.   I don't know why I thought the 'extras' (other than gold weight, hypoglossal anastamosis) wouldn't be covered.  I'll keep my fingers crossed when/if the time comes for those procedures.

Thanks you Senior Member!!!!!    Nancy

[daylilly]

Hi Cathy,
I had the gold weight and lower eye lift done and it was covered by BlueCrossBlueShield. The surgeon took a digital
picture of my eyes and submitted that to the insurance company prior to surgery. My AN eye has an extra crease. I
asked if I had that fixed would insurance pay for that and he said yes.  I am getting some facial movement so I have
not yet had any other procedures done. I also had a very stretched nerve. Did you get any movement on the AN side?
How have you taken care of your eye all of these years? Since I have had my eye done, I have not had to use drops
or gel. I went bike riding with my kids on a cold windy day and the eye felt great. My kids definately like my new AN
eye. I too have scared a few little ones. Hope your surgery will be covered. I would make sure to get preapproval on
any procedures.   Sue

[nancyann]

Sue,

I'm wondering how Cathy did it all these years without the surgery too !!!
Cathy, you must have ALOT of patience to deal with it.   I waited a month, a month too long in my opinion.

The wind still bothers me Sue, maybe it's because of the facial paralysis thing, don't know.  Glad to hear you 'rode like the wind' !!!!

Take care, Nancy

[nancyann]

Hey Cathy,

Hope you're still checking the site !!

Just wondering how you're doing, if you've decided on anything for your eye issue.

Take care, nancy

[antoinette]

Hi Cathy
I am surprised they didn't reattached the facial nerve in all that time.It is a natural follow-up procedure
I may have miss something. Where are you located?
Is there a chance you could consult the doctors at House Ear Clinic. or dr. Chang.
Raydean will help you find some place very trustable, as I am sure your doctor should have help you recover from such outcomes.
9 years is a long time to remain embarrassed because of physical appearance.
But I am sure your friends and loved one do not even see it anymore.
antoinette