Will insurance pay for a revision rhinoplasty if the cartilage in my septum is deteriorating? (photos)

Question

i had a rhinoplasty almost 20 yrs ago. I had the bridge of my nose narrowed and my columella fixed (obviously not anymore). Recently I noticed in pics my septum is crooked and my nostrils are large and uneven. I was once very happy with the results but not so anymore. When I feel inside my nose, the cartliledge in my septum in the right has a divet and the left side has a small protrusion. Is it possible for cartliledge to disintegrate? Will insurance pay for this? Do I need a bone graft?

Jose Barrera, MD · Answer

Insurance authorization can be requested for revision rhinoplasty in cases of nasal obstruction, persistent deviated septum, or saddle nose deformity causing valve stenosis. A complete evaluation will need to be performed by a rhinoplasty surgeon who specializes in septoplasty and revision rhinoplasty.

William Portuese, MD · Answer

A revision rhinoplasty is considered cosmetic and not covered by any insurance plan because there is no medical necessity to change the shape of the nose. The photographs demonstrate a hanging columella, which can be improved with a columella plasty. Other adjustments to the nose can also be performed as necessary. Nasal obstruction in the back of the nose can be considered medical necessity,  such as a deviated septum and a functional septoplasty is performed for that. For more information  about the differences between a septoplasty and a rhinoplasty,  please see the video below

Kailash Narasimhan, MD · Answer

Dear kmcfet,Septoplasty in general can be covered by insurance if there is documented nasal obstruction, blockage, or collapse of the nostrils (nasal valve).  Often this is an process involving writing to your insurance company for benefits and a waiting process.  A formal nasal exam including a few basic tests can verify this.  To your second point ,cartilage can disintegrate if there is trauma or scar in the area.  This can happen even after surgery.  It would be hard to tell per say how much cartilage is left in your nose unless it was examined formally.  Hope this helps and good luck!Dr Narasimhan

Eugene L. Alford, MD · Answer

Insurance does not pay for cosmetic surgery but if you have a functional problem with your nose insurance might pay to fix that The only way to know for sure is to see a Facial plastic surgeon who can write a predeterminatuon of benefits letter to your insurance company and they can then tell you ii the surgery on your nose will be covered.

Richard W. Fleming, MD (retired) · Answer

Health insurance companies typically contribute to the cost of fixing functional problems but there are many different policies. My office staff will help our patients communicate with their insurance companies before surgery to try to answer your question.

Will insurance pay for a revision rhinoplasty if the cartilage in my septum is deteriorating? (photos)

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