Combining Nose Jobs?

I have breathing difficulties due to my crooked nose. It blocks off one of my nostril passages and my parents urge me to get a nose job to fix the problem. I am extremely conscious of my nose, how crooked it is, its size and shape. Although the main reason for my nose job would be to help my health, as you could imagine, i dont want the outcome to be unsightly. How much more would i have to pay on top (as it obviously wouldnt be covered by medical insurance) and is this even possible?

Doctor Answers 11

It is common to combine nose surgeries

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It is difficult to be specific without seeing pictures. However, I can tell you it is common to do other procedures along with a surgery that improves breathing, which most often involves straightening the septum during an intranasal procedure and generally can be done without changing the external appearance of the nose. However, the external appearance can also be straightened and other changes made at the same time, which would be paid for out of pocket. The fees vary depending on the surgeon and how much work is involved. Sometimes other procedures are also recommended to improve breathing, such as spreader grafts that help straighten the septum and also change the external appearance.

Rhinoplasty, Septoplasty, and Turbinate Resection are often Performed Simultaneously.

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Your condition is not uncommon.  Many patients are unhappy with the appearance of the nose, often because there was an injury. Usually, what accompanies the injury is damage to the inside of the nose that causes breathing difficulties. 

In most situations, it is appropriate to perform nasal septoplasty which corrects an out-of-place septum.  Also, many people require turbinate reduction in the upper nose due to enlarged turbinates that add to the in internal nasal blockage.  At the same time, it is usually feasible to perform a standard rhinoplasty. Often, the chance of success, in strengthening a crooked nose, as you report, are enhanced when the internal operation is done. 

The saying long known to those of us who perform nasal surgeries is:  "As the septum goes, so goes the nose."  That means if there is a deviated septum, it may well be responsible for causing the crookedness of the nose and, therefore, must be addressed internally at the time the external portion of the nose is corrected cosmetically. 

A complete, valuable consultation a surgeon should include a thorough examination of the inside of the nose to determine the appropriateness of the internal nasal surgery to help straighten the nose and improve the airway. 

Finally, as far as fees go, it is impossible to quote a fee since these vary by location and, particularly, by degree of expertise of the surgeon.  Surgeons who are super-specialists in nasal surgery, whose practices are nearly exclusively to nasal surgery are apt to cost a bit more because they bring more experience, special talent, and evidence of success – as demonstrated by their photo gallery on their website - to the patient. 


Robert Kotler, MD, FACS
Facial Plastic Surgeon

Robert Kotler, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 90 reviews

Combining Nose Jobs?

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                    The two issues are addressed frequently during a single surgery.  Typical fee would be about $7000 or so.  Find a plastic surgeon with ELITE credentials who performs hundreds of rhinoplasties each year.  Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.  Kenneth Hughes, MD Los Angeles, CA

Fix the septum at the same time with rhinoplasty

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It's quite common to fix both the cosmetic aspects of the nose (rhinoplasty) and the functional aspects of the nose (septoplasty) at the same operation. In face, it makes a lot of sense to combine the two: one anesthetic, one recovery period, and all options available (e.g., septal cartilage for rhinoplasty grafts, etc.).

The surgery for the deviated septum is covered by one's insurer generally. It may be important, though, to get prior approval for the septoplasty from one's insurer so that the insurance company doesn't later deny the septoplasty entirely under the impression that it's being done merely for the aesthetics. The cosmetic component, of course, is the patient's responsibility. Even still, it's usually cheaper to do the two together.

All the best,


Pearson Facial Plastic Surgery®

David C. Pearson, MD
Jacksonville Facial Plastic Surgeon

Combining nasal surgery?

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I do not look at the septal or cosmetic issues as two different operations.  Fixing a deviated septum will help make a nose look straighter and is an important aspect of "fixing" the nose. As for the price, it will vary from doctor to doctor.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Combining Nose Jobs?

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I would encourage you to have your airway and the aesthetics of your nose corrected in a single operation.  The functional part of your surgery will likely be covered by insurance and this may involve altering or removing a portion of your septum.  I find the septal cartilage that is sometimes discarded or crushed and returned to the nose to be extremely useful in altering and controlling the aesthetics of the nose.  It would be a shame to forego the use of this valuable cartilage.  

Steve Byrd, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 22 reviews

Combining Nose Jobs

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If financially possible you would be foolish not to combine the correction of your breathing problem with the cosmetic changes. Ask your surgeon to talk to your insurance company to determine what the procedure will cost you - most will pay for the work to improve your nasal function, i.e. breathing. It will be much cheaper than having two separate operations.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Rhinoplasty and breathing surgery

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  There are multiple reasons why patients cannot breathe out of their nose such as a deviated septum, valve collapse, vestibular stenosis, and turbinate hypertrophy. Allergies can also cause breathing obstruction. If  there is  a deviated septum present and medical management such as nasal sprays and antihistamines are not helping, then consideration  for  surgery to improve air flow dynamics through the nose. This may include septoplasty, spreader grafts and turbinate reduction.   Medically related surgeries  are billed to the patient's insurance.   Co-pays  and deductibles will apply, and vary with insurance companies. Cosmetic rhinoplasty must be paid for by the patient themselves has not billed to  their insurance. Both surgeries can be performed simultaneously.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 reviews

Rhinoplasty for breathing problems is covered by insurance.

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Rhinoplasty for breathing problems is covered by insurance but not the cosmetic portion. You can have both done at the same time and have both a good functional as well as cosmetic results. see an experienced rhinoplasty surgeon for the best results

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 38 reviews

Septum with rhinoplasty

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The answer to this will vary office to office. For instance in my office I do not accept insurance so when I fix a patients septum during their rhinoplasty I simply consider it part of the rhinoplasty and do not charge any added fees. I'm sure other rhinoplasty specialists approach this differently but that is how we handle this issue. I would be wary of anyone who would charge your insurance for the septoplasty and "throw in" the rhinoplasty as frequently  this is done by younger surgeons trying to increase their experience,.although I'm sure this isn't always the case. Good luck!

M. Sean Freeman, MD
Charlotte Facial Plastic Surgeon
4.7 out of 5 stars 55 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.