How long should one wait between having a Septoplasty and a Rhinoplasty or Chin implant? I would like to have it all done at the same time, but my insurance will not cover a Septoplasty if it's done by a cosmetic surgeon.
How Long Should One Wait Between Septoplasty and Rhinoplasty?
Doctor Answers 8
Which first septoplasty or rhinoplasty?
Septoplasty and rhinoplasty are best performed at the same time. The cartilage removed in septoplasty can be used for aesthetic purposes in rhinoplasty. In some noses, there is a cosmetic deviation of the nose which is best improved at the same time as a septoplasty as well. If your surgeon participates with insurance, should be able to do at same time.
Why was your septoplasty not done at the time of your rhinoplasty?
You are describing a rather unfortunate episode. Frankly, it is important that a surgeon do a complete nasal examination prior to the surgery to determine if, in fact, other things, besides changing the outside of the nose, need be corrected. If you are said to need a septoplasty now, then you probably needed it before the surgery, unless the surgery created some change. Was your nose crooked before the surgery? Without having checked it before, it is hard to know. If you are saying that your breathing was not a problem, but now it is, then, mostly likely, the septum may have shifted. It was not necessarily the surgeon's fault.
The answer to how long you must wait really depends on how much was done cosmetically. I cannot answer that without viewing the inside of your nose and evaluating the incision, etc. Frankly, it is probably safer to wait at least six months after your surgery because there are going to be some minor changes and, perhaps, the crookedness will improve spontaneously, or it may worsen.
In any event, it is generally wiser to wait. Some surgeons would wait, even up to nine months. I know you are not happy with the difficulty breathing, but you do not want to do anything hastily that might negatively impact the outcome.
Robert Kotler, MD, FACS
Facial Plastic Surgeon
Author, SECRETS OF A BEVERLY HILLS COSMETIC SURGEON
Author, THE ESSENTIAL COSMETIC SURGERY COMPANION
Septoplasty and Rhinoplasty
You're insurance will cover the septoplasty under a plastic surgeon if that individual takes insurance. If they have chosen to not take insurance you may want to get another opinion. In my practice, I routinely bill the insurance carrier for breathing related surgery if we are to also do cosmetic surgery at the same time. They will cover time in the OR for the septoplasty and pick up a majority of the fees for the anesthesiologist and facility. Then a cosmetic fee is billed separately for the rhinoplasty. In this scenario, it is very important to find a Double Board Certified Facial Plastic Surgeon/ENT to do the procedure at the same time. This will save you time, money, and hassle in the recovery period. If you have no choice but to proceed in the manner you described...get another opinion...it will be a far better outcome if the nose is accessed once and not twice!
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Septoplasty & Rhinoplasty best done together
Rhinoplasty and septoplasty are often combined in one session. This is helpful for a number of reasons including:
Only one anesthesia and recovery
Using septal cartilage for rhinoplasty
Septoplasty after rhinoplasty can change shape of nose
Do them together.
The insurance company pays for surgery that is done to correct a breathing problem. They do not pay for cosmetic surgery. The surgeon often does both no matter whether he is facial or general plastic surgeon.
Septoplasty and Rhinoplasty Should Be Done at Same Time
A septoplasty is peformed to improve breathing that is blocked by a deviated (crooked) septum. A rhinoplasty is a surgery performed to change the shape of the nose. Frequently, during rhinoplasty, cartilage grafts are needed straighten, strengthen, or reshape the nose. If the cartilage from the septum has already been removed during a previous septoplasty, the results of your rhinoplasty could be sub-optimal or require alternative cartilage grafts from the ear or rib.
It is much better to have both the septoplasty and rhinoplasty performed at the same time.
Having them done separately is a bad move!
All three procedures should be done at the same time. I cannot imagine that your insurance carrier has really made the statement about not allowing the septoplasty to be done by an aesthetically oriented surgeon. I do a septoplasty on almost all of those who undergo rhinoplasty in our practice. At times the septoplasty is covered by a third party payor and I am an aesthetic surgeon ! Additionally having the septoplasty done by one surgeon and the rhinoplasty done by a second surgeon can put the second surgeon in a very difficult position if septal cartilage is needed in the case. Chin augmentation can be done separately but we often do these procedures under the same intravenous sedation anesthetic. There is a cost savings as well as decreased overall recovery time! Find someone qualified to do all three together and you will end up much happier!
Septoplasty and Rhinoplasty are best done together.
In my opinion, it's best to perform a septoplasty and rhinoplasty at the same time. Re-operating on the nose adds complexity, difficulty and risk.
While insurance will not cover the cosmetic rhinoplasty part of the procedure (nor should it), the septoplasty component should be covered--provided that it's being done for functional reasons and provided that medical management of nasal obstruction has either failed or is unreasonable.
Insurance companies are wise to the fact that unscrupulous doctors have tried to sneak a rhinoplasty through the insurance company rather than requiring the patient to pay. That's where this issue arises.
A surgeon trained and board-certified in both otolaryngology (ear, nose, and throat) and in facial plastic surgery should be able to clarify all of this pre-operatively with one's insurance company. Plus, an otolaryngologist is also adept at diagnosing and treating those functional aspects of the nose.
All the best,
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