Rhinoplasty for Medical Reasons Vs. for Cosmetic Reasons

I'm having surgery for medical reasons as I broke my nose in a fight and it affects my breathing, and was wondering if the surgeon would do anything different because it is for medical reasons not cosmetic? Lots of answers on here are for altering noses for beauty, but only a few for medical reasons (that I've found) Is there a difference? Besides what actually happens in the nose.

Doctor Answers 15

Reasons for Rhinoplasty Surgery

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A rhinoplasty is considered a cosmetic procedure, intended to make the patient look and feel better about his or her appearance. Meanwhile, a septoplasty is the medically necessary counterpart to a rhinoplasty, and is more often recommended for patients with difficulty breathing. The two procedures can also be combined in a septorhinoplasty, which combines the cosmetic components of a rhinoplasty with the medical components of a septoplasty. To help determine which surgery, if any, would best suit your needs, consult a board certified facial plastic surgeon in your area and evaluate your situation in person.

New York Facial Plastic Surgeon
4.7 out of 5 stars 79 reviews

Medical rhinoplasty

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What you are referring to are two non-cosmetic procedures: reconstructive rhinoplasty and septoplasty/sub mucous resection. The second procedure addresses a deviated septum or other obstructive condition inside the nose. The former would involve delayed treatment of a nasal fracture or other trauma. The motivations for these operations differ from the cosmetic rhinoplasty as do the end goals, which are functional over cosmetic. Insurance companies have strict standards now for reconstructive nasal surgery, often requiring that it occur within a designated time after the trauma, that the patient establish proof that conservative methods such as allergy treatments have failed to improve the breathing, and that the injury be corroborated by MRI or CT scan. Ironically, they spend more on the scans than what they pay participating surgeons but the goal is to limit surgeries and to deter cosmetic cases from being submitted for coverage.

Trauma vs cosmetic

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The surgical repair for nasal airway obstruction is most often only septal work that is not seen on the outside of the nose.  Unless the whole nose shifts to one side then it should appear more mid line.  What will be most noticeable is an improvement in your ability to breathe.

Functional rhinoplasty

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Anytime rhinoplasty for cosmetic purposes is performed, the functional components of the nose should be improved or at least respected and preserved.  Improving nasal function after nasal trauma is paramount and should go hand in hand with improving cosmesis.  Seek an experienced rhinoplasty surgeon for both aspects.  

Etai Funk, MD
Houston Facial Plastic Surgeon
4.9 out of 5 stars 69 reviews


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Ideally a board certified plastic surgeon (who performs cosmetic surgery) would reset your nasal bones (if they are displaced), while a board certified Ear Nose and Throat surgeon (who can work on your nasal passage) would help your cosmetic surgeon by making you breath better. Plastic surgeons are more inclined towards making noses beautiful at the expense of some functional compromise, while ENT surgeons are more functional in their approach. There are plastic surgeons who are good septoplasty surgeons, and many ENT surgeons are good rhinoplasty surgeons, but that's the exception not the norm. Pick your Dr.s carefully, and let your main concern (not coverage issues) guild you as to who to go to. Shop around for the right skill sets.

Ayman Hakki, MD
Waldorf Plastic Surgeon
4.5 out of 5 stars 34 reviews

Functional vs. Aesthetic Rhinoplasty

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This is a fantastic question! Yes, there is a difference.  On one hand, functional rhinoplasty improves nasal breathing versus cosmetic which only addresses the aesthetic aspects.  You can have both address, one, or both depending on the areas which you feel need to be addressed.

Richard Ellenbogen, MD
Los Angeles Plastic Surgeon
4.7 out of 5 stars 30 reviews

Rhinoplasty - medical vs cosmetic

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Hi Cazz. There is a difference between functional and cosmetic nasal surgery (rhinoplasty), although similar techniques are used for both. When nasal surgery is performed for breathing difficulty or deformity, it is referred to as functional or reconstructive surgery. In the US, health insurance usually covers functional surgery for breathing issues, and may cover reconstructive surgery if the cause is medical or the injury is recent. Surgical maneuvers to fine-tune the nasal appearance in ways that do not improve function are considered cosmetic. Frequently, patients who will be undergoing functional / reconstructive rhinoplasty wish to utilize that opportunity to have cosmetic work performed - since they will already be under anesthesia and the surgeon will be already working on the nose. Functional / reconstructive nasal surgery can be combined with cosmetic nasal surgery if there is some purely cosmetic issue that you would like to have addressed at the time of surgery. I hope that helps your understanding. Good luck.

James M. Pearson, MD
Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 137 reviews

Rhinoplasty fo Functional and Cosmetic Indications

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I'm sure your surgeon will make cosmetic and functional changes to meet your individual needs and improve your nose during your rhinoplasty surgery.

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

Rhinoplasty to correct breathing after nasal fracture

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The overall approach to the nose in either a functional or cosmetic case is similar. If you only want the breathing to improve then straightening out the deviation of the nose and septum should help. Depending on your anatomy structural gratts (spreader graft, alar batten graft) may also help with both of these issues.

Thomas A. Lamperti, MD
Seattle Facial Plastic Surgeon
4.9 out of 5 stars 22 reviews

Surgery for breathing

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If your only concern is breathing and you are happy with the way your nose looks then you don't need a rhinoplasty and it is considered a functional (or medical) vs. a cosmetic procedure.

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 231 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.