Who Should Foot the Bill for Revision Rhinoplasty?

Question

About two months ago I had an open Rhinoplasty to fix a deviated septum. It seems to have fixed the problem, however my nose was supposed to be straightened but is actually worse now and more crooked than before. There is only a little swelling but even my surgeon can see how crooked it is and knows it's not the swelling. 
 I'm from Canada and the first surgery was covered by the government being that it was a health issue. Now my surgeon told me yesterday that the revision to fix my more crooked nose may not be covered because my septum deviation is fixed. I can see the government saying "you fixed the deviated septum and screwed something up so why should we pay for that". 
 If that were the case the surgeon should foot the bill I think because I was not told before hand that if something went wrong then too bad for me or that there would be a chance I can't get it fixed or I'd never have had it done. So in the end someone’s paying for it because this was something that went wrong, not something that just naturally occurred.

Kris M. Reddy, MD, FACS · Answer

Sorry for the stress that the process has placed on you. Your surgeon should have a policy regarding revisions, and that should be explained to you prior to your original surgery. Your surgeon still has a vested interest in ensuring your happiness. If you trust that he/she can do a good revision, then work with him/her in a calm but persistent manner to come up with an equitable solution. Without government assistance, you should expect to pay at least the facility fees and anesthesia costs in this scenario. If you have lost confidence in the surgeon, consult with 2 - 3 experienced and expert surgeons to understand your options.

Jason B. Diamond, MD, FACS · Answer

The issue you raise is a good one. Your surgeon should have a financial policy that takes into account all possible scenarios. In general, if a surgeon messes something up so to speak they will usually fix it at no charge. If there is a healing issue that is not the surgeons fault then you will usually be required to cover the operating room and anesthesia costs. This is the model that most people in the states follow and I think it is a fair one.

Richard W. Fleming, MD (retired) · Answer

Dear Diana: I am not familiar with the Canadian, but you do raise an important question. Before the original surgery, I discuss possible charges if revisions are necessary. This will vary depending on each patient's needs and desires. Good luck fulfilling your goals.

Richard P. Rand, MD, FACS (retired) · Answer

First of all, if you needed an open rhinoplasty to correct your septum, that generally indicates a severe septal problem to begin with.  Without knowing exactly what was done, generally a window of the deviated cartilage and bone needs to be removed from between the mucous membrane leaves on either side of the septum.  An "L" shaped strut needs to remain along the dorsum and columella for support.  
No surgery is complication free and you have had one.  It is possible a mistake was made but beyond anything the surgeon did wrong, cartilages are not always sturdy and can warp and bend distorting the nose.  I would keep a good relationship with your doctor and see what they can do to help you with this.

Who Should Foot the Bill for Revision Rhinoplasty?

Answers (4)