How Soon Can I Have a Full Rhinoplasty After Septoplasty?

Question

Hello i had my surgery 9 days ago from a ENT doctor she shaved my bone spur down and gave me a tip graft which has fallen alot since 3 day ago. Im worried about the bone spur because the doctor left some layer of bone there and you can see it im feeling like all that was for nothen i heard bone spurs can grow back is that true when its shaved? and will my tip continue to fall? What are my options now for my insurance to cover any revisions since the surgery was already done under breathing?

Ran Y. Rubinstein, MD · Answer

Ten days is too soon to judge your results. It takes about 6 weeks to see the full benefit on breathing post septoplasty and up to one year for the rhinoplasty. Follow up with your surgeon and express your concerns.

Frank P. Fechner, MD · Answer

You ask many important questions re: revision nasal plastic surgery. What is interesting is that you are considering revision surgery as early as 9 days after your original surgery. At this point, it is best to focus on your healing as you will notice significant changes over the next 6-9 months. Not all of these changes will be to your liking, I assume. Still, revision rhinoplasty should be postponed until that time.

Gregory Turowski, MD, PhD, FACS · Answer

Sounds like you had more correction than just septoplasty. Is sounds more like septorhinoplasty. Usually any revision surgery involving nose should be done not sooner than 1 year after the first procedure. Please do not rush with any decisions until you are fully recovered. At this point you are in healing process and the nose you are looking at will still change in shape and size. You are probably still very swollen and most patients after only 9 days from surgery find breathing still difficult. As far as the insurance coverage you have to check with your insurance company. Every patient has different plan and benefits under that plan. Please talk to your surgeon and he will explain what are the chances for your case to be covered by your insurance.

James Chan, MD · Answer

I generally ask my patients to wait 9 to 12 months after nasal surgery before considering any revision. It is likely that the appearance of your nose and the functional aspect (breathing) will continue to change for many months-- many times for the better, so being patient is important as well as talking to your surgeon about these changes. My experience with insurance is that they will usually cover any medically necessary surgery that addresses the functional aspects of your nose (eg breathing). However, you should check with your particular insurance policy to determine what your benefits are.

Sam Naficy, MD, FACS · Answer

10 days post surgery is still very early for you to judge the results of your surgery - be patient and follow up with your surgeon. Ideally you should wait ate least a few months before seeking revision

Robert Kotler, MD, FACS · Answer

Hello SLO2012;

	I am curious why your surgeons would not do a rhinoplasty and septoplasty at the same time.  There are advantages like saving dollars and your time.  One operation, one anesthetic, one recovery period, and big savings, dollars and cents-wise. 

	If the septoplasty has been successful and your breathing is better and you are satisfied, then, of course, you should have the rhinoplasty because you are obviously not happy with the external appearance of your nose, but I would certainly wait until three to four months and until your surgeon feels that the septal healing is complete.  I assume that at this point your breathing is better and all the symptoms this generated your need to have the septoplasty are absent. 

	With respect to your question concerning insurance, that is something you need to discuss with the office manager regarding your insurance policy and what benefits may or may not be available for revision septal surgery. 

	Robert Kotler, MD, FACS
	Author, SECRETS OF A BEVERLY HILLS COSMETIC SURGEON
	Author, THE ESSENTIAL COSMETIC SURGERY COMPANION
	Original cast member, Doctor 90210
	robertkotlermd.com

Francis R. Palmer, III, MD (retired) · Answer

Minimum of 6 months, before you couls have a Revision Rhinoplasty,  because you technically had a Setorhinoplasty since the nasal tip was worked on (tip graft).  Hope this helps.

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