Combining septum surgery and rhinoplasty.

I need surgery to straighten my septum to improve my breathing. I would like to combine it with a nose job (shave my small bump and mostly shave my nose bone to make it smaller). Is the straightening of septum something that plastic surgeon are good at and what do insurance company usually cover? Thanks!

Doctor Answers 8

Photos for better advices

Thanks for the question. 

I recommend you to send your photos to us to give you the advices you need and want. 

Kind regards  

Dominican Republic Plastic Surgeon
4.7 out of 5 stars 256 reviews

Rhinoplasty and septoplasty...

If you have ever thought of doing rhinoplasty, then you would definitely want to do that at the same time as your septoplasty. Most insurance companies cover the septoplasty procedure if the correct documentation is provided by the surgeon. You should seek out a plastic or facial plastic surgeon that specializes in rhinoplasty - that way you know they will good at working on the septum as well.

Andrew Miller, MD
Edison Facial Plastic Surgeon
4.8 out of 5 stars 205 reviews

Rhinoplasty and septoplasty

Experienced rhinoplasty surgeons can perform septoplasty also. You should definitely do them together as they are really related and except in the most simple cases not two different operations. The cost issue varies by insurance company and you should discuss it up front to avoid unexpected problems. Surgeons also vary and some will bill insurance while other's don't do it routinely.  This billing part is complicated and changing all the time so check with both your surgeon and the company.

Wayne F. Larrabee, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 18 reviews


Cosmetic procedures are not covered by insurance.  The septum deviations may be covered if you can document an airway issue.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Combining septum surgery and a rhinoplasty

A septoplasty is usually performed by ENT/ facial plastic surgeon, however a very experienced rhinoplasty surgeon will know how to perform a septoplasty. Medical necessity must be documented  at the time of the examination in order to bill medical insurance. The rhinoplasty procedure is more complicated than a septoplasty and takes a longer period of time to accomplish during surgery. For more information describing the differences between the two procedures and many before-and-after examples, please see the link and the video below

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 143 reviews

Septoplasty and rhinoplasty

Hello and thank you for your question. Combining a septoplasty with a rhinoplasty is very common.  Depending on your insurance provider, the septoplasty portion can usually be covered.  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

Richard G. Reish, MD
New York Plastic Surgeon
5.0 out of 5 stars 125 reviews

Combining aesthetics and function in Rhinoplasty

You have asked a very important and pertinent question.  Put simply in a nutshell the surgery of the septum and rhinoplasty are always associated with each other and to seperate them or to involve a surgeon for the cosmetic enhancement and another for the functional part only means that both surgeons are NOT trained specialist rhinoplasty surgeons.  The aesthetics of the nose and function of the nose are inseparable and hence an expert rhinoplasty surgeon who is trained in both Otolaryngology/ENT surgery and Facial Plastic Surgery is the only type of surgeon that can address both problems at the same time.  The opposite is also true in that an ENT surgeon should not attempt to straighten a septum if the patient is concerned with the aesthetics of the nose and a plastic surgeon should not perform cosmetic surgery on a nose with a crooked septum unless they are able to correct the septal deformity.  This problem often co exists together and often times a crooked septum is the cause of the external nasal deformity.  Shaving a hump in nose with a crooked septum will often result in a more deformed nose.  

In my practice, I often see patients requiring revision rhinoplasty surgery due the original surgeon's initial poor assessment followed by a poorly executed operation that does not address both issues at the same time.  

To sum up, choose a facial plastic surgeon who is trained in both fields or a plastic surgeon who is trained in nasal airway surgery.  Yes, insurance does cover some aspects of this surgery depending on the level of cover you have.  Hope this helpful.  

Septoplasty & Rhinoplasty

Facial plastic surgeons are trained to take care of the functional aspects of the nose as well as the cosmetic aspects. If you are considering having both done, they should both be done at the same time so that if grafting material is needed, it can be obtained from the septum.  

Insurance typically covers only the functional aspects of surgery, like the septoplasty. So in most cases there will be additional surgery, facility and anesthesia costs.  Occasionally there are other aspects of the surgery that can be covered, but an in person consultation is needed to see if that is appropriate for you 

Good Luck!!

Samir Undavia, MD
Princeton Facial Plastic Surgeon
5.0 out of 5 stars 38 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.