My nose is very deviated and I have difficulty breathing, prone to sinus infections, severe congestion, sinus headaches.I think about 25 of by breathing enters through the right nostril and 75% the left. I am required to sleep on my right side (so that left nostril is on top) in order to breathe at night, or else my nose becomes completely clogged within seconds. I am wondering if septoplasty will be sufficient, or if rhinoplasty be required to restructure my nose? What can I expect to pay?
Rhioplasty needed w. septoplasty to correct my breathing problem? Is rhinoplasty ever medically necessary?
Doctor Answers 7
Is Rhinoplasty Ever Medicallt Necessary?
If you have deviation of the entire nose, including the septum, it may be necessary to straighten the external nose, which will change the appearance, to improve your breathing. After evaluation my staff will always try to help a patient determine what the insurance company will cover.
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Rhinoplasty, septoplasty, sinus surgery
A septoplasty is performed when the cartilaginous and bony septum is crooked enough that it is creating a breathing problem. There are other anatomical issues inside the nose that can cause breathing obstruction, such as turbinate hypertrophy, valve collapse and vestibular stenosis and allergies. Each one is treated differently. Sinus related problems are caused by allergic nasal polyps located inside the sinuses which create chronic sinusitis and sinus headaches. This is treated with endoscopic sinus surgery when chronic in nature. A rhinoplasty is considered cosmetic when it is changing the outside shape of the nose and must be paid for by the patient themselves.
If you have airway obstruction and it is due to a deviated septum, then certainly a septoplasty may be beneficial.
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Rhinoplasty or septoplasty or both?
Rhinoplasty is a procedure to reshape the nose, septoplasty either removes the septum (central keel running down the middle of the nose) or reshapes the crooked septum. A crooked nose with breathing difficulty can cause all of the the symptoms you describe. To know if a septoplasty will be "sufficient", depends on what part of the nose is interfering with normal breathing. If the nose bones, different cartilage structures need reshaping then yes, a rhinoplasty and septoplasty will both be needed.
Rhinoplasty with septoplasty
From your photograph and the description of your breathing problem, you might have a right deviated septum, and there might be some contribution to the obstruction from the indent over the right side of your nose. There might be some benefit in terms of your obstruction from correcting your septum and opening up your right side internal nasal valve.
In short, some nose obstructions do indeed require changes to the external appearance in order to help the breathing. This is not a cosmetic procedure. Getting it covered might be difficult.
Cost of Septorhinoplasty
The medically necessary part of any nose surgery is the internal procedures of septoplasty and turbinectomies which has some influence on one's ability to breathe through their nose. In most cases, these are insurance covered procedures which are usually approved. They would need to be done as part of your nose procedure. To correct the deviated part of your nose and any other aesthetic changes, that would not be covered by insurance. Thus many septorhinoplasties involve a combination of insurance covered and out of pocket cosmetic expense. The best way to determine what that approximate cost for the rhinoplasty portion would be is to submit photos to the doctor and ask for a cost estimate. Then he/she can see exactly what needs to be done.
Rhinoplasty needed w. septoplasty to correct my breathing problem? Is rhinoplasty ever medically necessary?
Your sinuses should be assessed as well as the internal nasal anatomy to determine an anatomic cause that is consistent with your breathing problems and headaches. Cosmetic issues can be addressed with rhinoplasty techniques.
Kenneth Hughes, MD
Los Angeles, CA