to me this sounds like an oxymoron. my septum is twisted from a deviation.my nasal bone is also deviated. both recieved after having my nose broken then never having it reset i suppose. i asked my doctor if he is going to straighten my nose bone, and he said only if my airway is still obstructed. my question is , can a proper septoplasty be performed when there is a 50 to 60 % deviation in the nasal bone? and if i was approved for rhinoplasty, WHY does it seem like the doctor is avoidingdoin it?
My Insurance Company Approved Me for a "Non Cosmetic Rhinoplasty"
Doctor Answers (8)
Your question is appropriate and your concerns are valid. From your history correction of the septal cartilage and the bone would both be non-cosmetic and should be covered even if the nasal bone deviation is not obstructing the airway. The key point is that your nose i.e the bone was broken so fixing it is not cosmetic. You are also right that septoplasty alone in the face of septal cartilage and bone deviation will not straighten the nose. Why does your surgeon not want to address the bone issue? The bone may not be easy to address in that if you rebreak it it can break into small pieces whose position you cannot control. This is where crushed cartilage grafts for camouflage and rasping of bone spurs come into play to give you a more symmetric bone shape as well. You need to discuss this with your surgeon before surgery.
I hope you realize that this format of posting questions and receiving answers lacks the face to face direct communication required for you to make an informed decision regarding your surgery.
My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.
Insurance coverage for nasal airway obstruction
Insurance companies will usually cover nasal surgery if there is significant nasal airway obstruction. It is important to differentiate between a surgical procedure done for purely cosmetic reasons vs. one done for purely functional problems. The key to a straight nose is a straight septum. In some cases this may involve a reset of the nasal bones especially if they were shoved to the side due to trauma.
Insurance Approval for "Non Cosmetic Rhinoplasty"
Sometimes, it is necessary to change the appearance of the nose when moving the nasal bones so we can straighten the underlying septum. This cosmetic change is covered by many insurance companies because it is necessary to improve nasal function. Both your surgeon and your insurance company should clarify your personal responsibility as much as possible.
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Insurance versus cosmetic issues related to nasal surgery
Unfortunately, the term "non cosmetic rhinoplasty" can and does create significant confusion. You need to find out from the insurance company exactly what they mean by this term and what it includes. The bottom line is, though, they will cover correction of your septal deviation issues but not anything cosmetic on your nose such as a bump or tip work. Whether their coverage includes addressing deformity of the nasal bones needs to be clarified.
When nasal trauma causes damage to the underlying anatomic structures, often times this can lead to deviation of the septum and nasal airway obstruction. These are considered functional problems that need to be reconstructed as opposed to a cosmetic rhinoplasty (e.g. reducing a nasal hump, narrowing the tip or alar base, etc.) A septoplasty will help correct septal deviation to improve the breathing. Please consult with a board certified specialist who can assist you.
Non Cosmetic Rhinoplasty
After a nasal trauma such as yours, straightening the septum and rebreaking the bones to straighten the outer part of the nose is indeed reconstructive. If you want your surgeon to lower a bump on the top of the nose or make the tip look better by altering the tip cartilages, those procedures are cosmetic and you should expect to pay for them over and above the insurance. If you have traumatic distortion of the bones and your doctor has not discussed doing the necessary corrective surgery to fix that distortion, you need to seek a second opinion.
Non Cosmetic rhinoplasty may include breaking the bone
Although I don't like the term non-cosmetic rhinoplasty, I would think you are talking about a reconstructive septorhinoplasty. This is one done following trauma to the nose causing a deformity as well as a devisted septum. It may include a cosmetic portion for tip work and other things done during the surgery which you would have to pay for separate from the insurance. This should be discussed with your doctor in advance of surgery. Sometimes it is necessary to break the nose in order to get a straight septum and vice versa, so if the nose and septum are crooked then you would need to fix both to achieve correction. Good luck from Dr. Schuster in Boca Raton.
If portions of the external visible part of the nose is twisted or crooked because of trauma, disease. ora deviated septum some insurance companies will still approve surgery to fix it. This does not include removing a naturally occurring bump, or making any other changes to make the nose "look" better. This would be cosmetic and you should expect to pay separately for it if you want those things fixed. If you do have cosmetic issues I would recommend getting everything done at once.