Would you recommend that I get rhinoplasty without insurance?

Your question brings up several issues.
One issue is whether a CT scan will be ordered. A CT is not necessary for evaluation of the external shape of the nose. That assessment is done by the surgeon looking at the nose and in the nose, and by feeling the nose. A CT scan would be required if there is suspicion of sinus disease or maxillofacial trauma.
A second issue is that of insurance. Improving the appearance of the nose is not covered by insurance anyway, so the point is moot. Plus, many (most) insurance policies do not cover complications arising from cosmetic surgery. Example: patient has an intra-operative heart attack (exceedingly rare, I know, but possible) that now requires an ICU admission, cardiac catheterization, echocardiogram, specialist consults, etc... tens of thousands of dollars of care or more. Most times, your insurance will not cover that since it was subsequent to cosmetic surgery.
There is a company or service I saw once (can't recall the name) that specifically offered coverage for just this scenario for plastic surgery patients.
The last issue that you raise is one of patient compliance. If a patient does not want to follow the doctor's recommendations, such as getting a CT, then it's probably best that the patient finds another doctor. Doctors don't get paid for ordering tests. We don't order them for our amusement. We order them when our clinical judgment suggests it's helpful in the care of the patient.
All the best,
--DCP

Hello!  Thank you for your question.  A CT scan is not completely necessary for a rhinoplasty, but your surgeon may be looking for something specific for surgical planning.  It will be up to your surgeon if he requires.  You should discuss with him/her.  Best wishes!

I think you may be confusing two different issues.
Surgeons rarely need a CT scan for a rhinoplasty. However, they frequently request it when contemplating a functional rhinoplasty in which the sinuses or breathing disorders are also being treated.
Plastic surgeons will not likely refuse your request but in this era of defensive medicine, they may request that you sign a document stating that you refused the recommendation.
If you are seeking to improve your breathing, then I would advise you to get a CT scan to make sure there are not other causes for your obstructive symptoms.
If, however, you want to only improve the appearance, then it is possible that a plastic surgeon would proceed without a CT scan

If your nose is very twisted then a rhinoplasty and possible septoplasty would be needed to straighten your nose. Do you have any difficulty breathing through your nose?
Most insurance companies will cover the surgeon's fee, and the hospital fee to repair a broken nose. Many of the Rhinoplasties I perform have both a functional, and cosmetic component. Although insurance won't completely cover your fees, you could save thousands of dollars if you have a health insurance policy.
For subtle deviations, Injectable Fillers can be used to straighten your nose's appearance. I've attached a photo demonstrating the use of Silikon-1000 to correct a crooked nose in a male patient. You can see widening at the area of correction which is improved.
I hope this helps, and best regards.

Hi S,
If you have had a history of sinus infections and wish to have possible sinus surgery along with rhinoplasty, then a C.T. scan of your sinuses would by indicated. A CT scan is not necessary for rhinoplasty or for straightening of the nose.
Most insurance companies will not cover rhinoplasty, consequently most rhinoplasty surgery is done without insurance. In the rare instance of a complication that would require hospitalization, then you would be responsible for the hospital charges. Hopefully Pres. Obama will have an insurance plan for you to get on in the near future.
Good luck and be well.
Dr. P

Unless you have significant breathing problems or a history of sinusitis, it is very unlikely that your plastic surgeon would want you to get a CT scan. If the purpose of surgery is simply to straighten your crooked nose, most plastic surgeons would rely upon physical examination and preoperative photographs to plan your operation.
It is imperative that you maintain an open line of communication with your surgeon. If you explain that you do not have health insurance, he or she will be less likely to order extraneous tests.
Best of luck!

Some insurance companies have required scans for preauthorization which is ironic because the scan costs almost as much as they pay in network doctors. This is probably part of a plan to deny payment or to create such difficult barriers to surgery that patients either give up or pay out of pocket.

A rhinoplasty is not covered by any medical insurance whatsoever and is considered completely cosmetic. If the nose has been broken by an injury it can sometimes be covered under a medical insurance plan if the procedure is simply to correct the nose for any breathing problems that was the result of the injury. A CAT scan of the sinuses is only needed for chronic sinus disease to diagnose chronic allergic nasal polyps located inside the sinuses. There is no reason to get a CAT scan of your nasal bones.

Rarely in my practice do I order a CT scan for patients that present with interest in performing a cosmetic rhinoplasty. As stated by some of the other specialists, insurance companies don't cover the cosmetic (or external, as they see it) portion of a rhinoplasty. They will cover internal problems causing airway obstruction or external problems caused by trauma or cancer.

If you don't have health insurance and are paying cash, you should speak with your surgeon about the procedure cost breakdown, that is, how much is he charging to repair the external appearance if you don't have significant airway obstruction. If the internal problems are significant enough to be causing some of the outward deformity such as a deviated septum, then you will need to have that treated also.

 If you are unhappy with the appearance of your nose, then a rhinoplasty is an option for treatment. I do not routinely get CT scans unless there are strong indications to obtain one. Usually this is related to breathing issues.