Can I Get a Nose Job for Free if I Have Been Referred to by a Doctor for my Nose?

Question

I recently broke my nose and had to get surgery to fix it but my cartilage needs to be reconstructed so I have been referred to a cosmetic surgeon. Am I able to get a free nose job if I have already been referred to one? Will he shave down parts of my nose I dislike?

Jeffrey Zwiren, MD · Answer

Alas there is no free ride. There are definite changes that are made to the nose for a reconstructive procedure and ones for a cosmetic procedure. Sometimes the differentiation is a very fine line. For example, if the nose is crooked and the septum is deviated then the only way to correct the nasal shape is to straighten the septum. By straightening the septum your breathing may be improved.

Robert Kotler, MD, FACS · Answer

Hi MILL;

	Unless your surgeon is your father or uncle, it is not likely that you are going to have a "free" operation.  If you broke your nose, you certainly need to have it fixed, and the most important chore you have now is to find a surgeon who is very experienced and can deliver satisfaction to you. 

	I am not sure what you mean by "free nose job."  Perhaps you are referring to a third partying paying, such as an insurance company.  Without more information, I cannot really answer your question.  With respect to his "shaving down parts of my nose I dislike," if that is what you want, and the surgeon thinks it can be done, go for it.  However, remember that if the broken nose occurred recently, some of the tissues are somewhat eggshell-like and are not appropriate for all elements of surgery.  When you consult with a doctor, you will have to ask about the timeline.  Now may not be the time to do all that you wish done.  The doctor will have to evaluate your breathing.  He will have to evaluate how much of the tissue has been broken and misplaced, and what should or should not be done currently, or what can be deferred until a later time.

	These are not simple decisions.  Therefore, I suggest you do your homework well and be sure to consult with cosmetic plastic surgeons who are very experienced in nasal surgery and who can, therefore, be more likely to satisfy you.  Sometimes, under the best of circumstances, it takes a second "touch up" operation to give an ideal result after a nose has been severely injured. 

	Robert Kotler, MD, FACS
	Facial Plastic Surgeon
	Author, SECRETS OF A BEVERLY HILLS COSMETIC SURGEON
	Author, THE ESSENTIAL COSMETIC SURGERY COMPANION

Steven Turkeltaub, MD · Answer

Insurance will cover the reconstructive part of your surgery - that related to your fracture - but will not cover the cosmetic component. Your surgeon will charge for this as will the facility and the anesthesiologist - this is not done gratis and for many reasons.

Peter E. Johnson, MD · Answer

If your nose have been damaged as a result of accident or injury insurance coverage is often available to help with the cost of rhinoplasty. The process should start with a predetermination from your insurance carrier so you can be certain just what will be covered, and to what extent. Just getting a referral is only the beginning. Also, as the insurance companies always say, determination of covered benefits is not a guarantee of payment.
	Best of luck, peterejohnsonmd.com

Barry L. Eppley, MD, DMD · Answer

Insuracnce will cover those portions of nose surgery that pertain to structures causing breathing problems. But when it comes to any changes of the external nose to alter its shape, that is a cosmetic procedure and you will be responsible for the cost of performing that part of the surgery. A prior history of a repaired nasal fracture does not mean that any subsequent nose surgery will be similarly covered.

Jeffrey Scott, MD · Answer

There are many factors with regard to rhinoplasty and cost. If it is trauma-related, sometimes insurance will cover a portion of the procedure. Consult with a board-certified surgeon to discuss the issue. With rhinoplasty, multiple opinions are particularly useful.

Gregory Pippin, MD · Answer

I am assuming that you mean will you insurance cover the costs of the procedure.  Insurance in general will cover some of the costs, however they will not generally cover cosmetic portions of the procedure.  You need to check with you insurance carrier prior to the surgery to see if it would be covered.  It is unlikely that they would cover the removal of the nasal bump.  Make appointments for consultations with multiple surgeons. Look at lots of before and after photos. Board certification by The American Board of Facial Plastic and Reconstructive Surgery, The American Board of Cosmetic Surgery, The American Board of Otolaryngology or The American Board of Plastic Surgery is preferred. Warmest regards.

	Dr. Pippin

Ricardo Izquierdo, MD (retired) · Answer

Your insurance will pay a portion of your nasal surgery for the reconstruction from trauma. You should understand that they will not pay for all of this portion, and you should check with your insurance documents regarding your deductible and co-pay. The cosmetic portion, to "shave down parts....I dislike" will not be covered. You will pay for this portion along with the deductible and co-pay out of your pocket.

Michael Elam, MD (retired) · Answer

When you are stating "free" surgery I am assuming you are inquiring if insurance will cover the expenses. This depends on your insurance policy and whether  the proposed procedure codes will be covered. Your surgeons office may preauthorize the procedure if necessary to confirm coverage. If your fracture was caused by an act of violence perpetrated upon you then some victims advocacy groups will pay for reconstructive work as well. Best regards!

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