Rhinoplasty at the same time as septoplasty - is it a good idea? (Photos)

Question

I'm having a deviated septum corrected in a few months and figured that it'd be a good time to get that nose job I've always wanted done. Is this a good idea or not? Approximately how much would I pay for it? Would it change recovery time? Might it impact my breathing at all? Would it be the same cost as getting rhinoplasty by itself, or would I save money due to my insurance covering the septoplasty?

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your
photograph, you may benefit from a tip refining rhinoplasty and osteotomies to narrow your mid nasal vault.  This can safely be performed at the same time as your septoplasty.  Cost varies based on geographic region and surgeon expertise. The septoplasty portion and anesthesia is usually covered by most insurance providers.  Make sure you specifically look at before and after
pictures of real patients who have had this surgery performed by your surgeon
and not just a computer animation system. The most important
aspect is to find a surgeon you are comfortable with. I recommend that you seek
consultation with a qualified board-certified plastic surgeon who can evaluate
you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Jeffrey Joseph, MD, FACS · Answer

Thank you for the great question.  Having been trained in ENT and facial plastic surgery, I almost always use grafts to make the nose function better as well as look more pleasing during rhinoplasty. The preferable material for grafts are from the patient'a own septum.  Therefore, if you are having septal surgery and ever thought about rhinoplasty, do them together.  It is cost effective and in one week, you most often can return to most activities.  I would recommend seeing two or three surgeons to get their ideas.  Wishing you all the best in this big decision!

Parker A. Velargo, MD, FACS · Answer

I routinely harvest cartilage from the septum to use as grafting material during a rhinoplasty.  If the septum is deviated, then removing the offending cartilage serves to help with breathing and to help with the rhinoplasty portion of the procedure. Sometimes, septal bone spurs are also present, and these are also addressed when a septoplasty is needed.  It is possible to separate the fees when having the procedure done simultaneously -- septoplasty/ rhinoplasty -- such that the insurance company helps with coverage of your septoplasty; however, it's best to look at your plan in detail with your provider beicause by the time you pay your deductible and co-insurance along with the cash rhinoplasty, you might come out cheaper not dealing with insurance at all.  Seek out the consultation of a board certified facial plastic surgeon or plastic surgeon. Good luck!

James Murphy, FRCS(Plast) · Answer

I'm afraid I'm not in a position to comment on the financial side of things. In addition, without a full functional assessment of your nose, I do not know what type of septoplasty you require or what effect it will have on your breathing. What I can say is that you should certainly try to see a surgeon who has the experience and ability to deal with both problems at the same time. There are a number of complex technical reasons why the two surgeries work well together and the surgeon who can deal with both should be able to demonstrate significant experience to tackle complex functional and aesthetic problems.

Paul E. Goco, MD · Answer

Thanks for your question and photos.  Yes, both are commonly done at the same time. Yes to all your other questions, also.  You will need to speak to your surgeon as to the specifics answers as a lot has to do with your anatomy and how their office conducts payments, etc.  Please be sure that your surgeon has adequate experience performing these surgeries at the same time.  You should be able to review a digital morphing photo of your before and after photos.  Best!!

Kris M. Reddy, MD, FACS · Answer

Combining a rhinoplasty and septoplasty into one procedure is very common. Moreover, the combination of the two into one procedure often produces better results due to influence of one procedure upon the other. Consult in person with an experienced and expert board certified plastic surgeon to understand your options.

Thomas Hubbard, MD, FACS · Answer

There are many reason to get a rhinoplasty at the same time as septoplasty rather than postpone the rhinoplasty to another time.   First of all if breathing is to be addressed a rhinoplasty has many effective tools that can improve breathing far beyond a simple septoplasty for a deviated septum.  Second, and just as important, is often the cartilage is discarded after septoplasty and that cartilage would have been very useful for shaping purposes or even further improvement of breathing with grafting techniques at the time of a rhinoplasty.   It's difficult to comment on cost as it depends on the area of the country so much and insurance coverage is even more difficult to predict.    Often though, insurance may pay for the functional part of a rhinoplasty, such as septoplasty, or even parts of the rhinoplasty itself if those parts are to address function.  Recovery would be changed somewhat as a rhinoplasty will probably have more swelling, but for decades the result will likely be superior and the breathing possibly significantly better with rhinoplasty in the hands of an experienced Board Certified Plastic Surgeon.

Barry L. Eppley, MD, DMD · Answer

The combination of a septoplasty and a rhinoplasty is both common and synergistic. Beyond their anatomic proximity, one influences the other in terms of surgical access, graft procurement and use and in the creating the relationship between form and function.

Jordan P. Sand, MD · Answer

Hi AL6001 and thank you for your question.
The combination of a rhinoplasty with a septoplasty is very common. Typically an insurance will help pay for the septal deviation (minus deductibles and co-insurance) while any cosmetic concerns would need to be paid separately. This can lead to some cost savings for many patients. Costs for the procedure really depend on the area of the country. If you look for average costs in the area where you live on this site, this may help you get an idea of the cost of a rhinoplasty. Rhinoplasty can definitely impact the breathing, and so you would want to ensure that your surgeon had adequate experience performing this procedure.
Doing the two together will likely not change your recovery time. I would recommend discussing the options with your surgeon.
Good luck!

William Portuese, MD · Answer

Yes, it is a good idea to undergo both the septoplasty and a rhinoplasty simultaneously under one anesthesia which also allows one recovery period. Functional nasal surgery such as a septoplasty can be billed to the patient's medical insurance, once medical necessity has been documented at the time of the examination, and preauthorization has occurred with your insurance company. Anticipate co-pays and deductibles. Rhinoplasty is considered cosmetic, and takes much longer to perform than a septoplasty. The rhinoplasty  must be paid for by the patient, including the surgeon's fees, anesthesia fees and operating room fees for the cosmetic component.

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