Plastic surgery has been growing by leaps and bounds in recent years. The demand for cosmetic procedures have led the way. Many people are unsatisfied with at least one part of their body. American society’s standard of beauty is ever changing, and body image is often dictated by popular culture. People are frequently influenced by celebrities, and this leads to imitation. Many women ask their surgeon for a specific body part associated with a particular celebrity. They may even try to match as many of that person’s features as possible. Body image has become somewhat of an obsession in our society. The nose is one of the main body parts that’s changed for aesthetic reasons. There are also medical conditions that necessitate surgical intervention. Cosmetic procedures can be very costly and health insurance only covers certain procedures.
Rhinoplasty (Nose job)
A rhinoplasty is known as a nose job, but it’s actually performed for a variety of reasons. It’s a surgical procedure to correct or rebuild the nose. This may be done for aesthetic or functional purposes. Nose surgery may be required to address cases of trauma to the nose, congenital defects, or breathing issues. Cosmetic surgery on the nose is done to improve appearance. These changes include narrowing nostril width and the overall size of the nose. Trauma to the nose and certain sinus conditions can necessitate a functional rhinoplasty. Trauma to the nose can occur during childbirth or when blunt force is exerted. This can result in injuries like a broken nose or deviated septum. Therefore, rhinoplasty can be elective/cosmetic, or medically necessary. The difference between a functional and cosmetic rhinoplasty is the main purpose of the procedure. The improvement of function is the primary concern in operations performed because of medical necessity. Cosmetic rhinoplasty is done for appearance only, and not for any particular health issue. The procedure can be performed by an otolaryngologist, a maxillofacial surgeon, or a plastic surgeon. It involves separation and correction of tissue in the nasal area. The area is then sutured and immobilized for the healing process, by use of various materials.
Septoplasty is a surgical procedure done to correct a deviated septum. This condition can be caused by an injury or trauma during birth. It results in displacement of the bone and cartilage in the area. This area that separates the nostrils is known as the septum.
Some patients are asymptomatic, while others experience varying levels of discomfort. Symptoms include nasal congestion, sinus infections, sleep problems, and difficulty breathing. Some symptoms can be treated with medication, but others will require surgery.
A crooked septum can reduce airflow, and the displacement usually blocks one side of the nose. Your sinuses are responsible for draining fluids from the nasal cavity, and a crooked septum can cause blockage and accumulation of fluid. The surgery straightens the deviated septum by cutting away displaced cartilage and/or bone, and then places them back in the correct position. The operation opens the airways and improves nasal breathing. A regular septoplasty is a functional surgery, and doesn’t include changing the appearance of the nose for aesthetics.
Elective/Cosmetic Surgery and Medical Necessity
Surgical procedures involving the nose can be classified as either medically necessary or elective/cosmetic. Medically necessary procedures are done to cure an illness or resolve a medical issue. Insurance companies have criteria that must be met before the costs of surgery are covered. This usually involves a list of symptoms matching your diagnosis and treatment plan. The doctor’s judgment plays a big role in the process. He or she determines the diagnosis and treatment plan for your condition. This is used by your insurance carrier to determine coverage. In some cases, the recommended procedure may not be accepted by your insurance company because they may consider it to be “experimental and investigational.” A surgical procedure that isn’t linked to a condition as a treatment option is usually considered as such. The effectiveness of the treatment must have proven success by generally accepted standards of medicine, to be considered a viable option.
Insurance Coverage for Rhinoplasty Combined with Septoplasty
Patients that are diagnosed with a deviated septum often choose to do a cosmetic rhinoplasty along with the septoplasty, because there are several advantages in doing so. There’s always a slight risk for complications during or after surgery. These include infection, excessive bleeding, and adverse reactions to anesthesia. Getting both procedures done in one operation lessens your risk of experiencing these complications. Another advantage is the savings in out of pocket expenses. The time spent healing will also be lessened. A diagnosis of a deviated septum does not mean automatic coverage. You have to consult with a surgical specialist and get a treatment plan for submission to your insurance company. A septoplasty that’s deemed medically necessary by your insurance company will be covered.
Most insurance carriers will only cover procedures that are medically necessary. A septoplasty that is being done to treat an illness, injury, disease, or its symptoms, should be covered if it meets accepted standards of medicine. This operation is considered a functional rhinoplasty. Insurance carriers won’t cover a rhinoplasty done solely for aesthetic purposes. A septoplasty can improve the appearance of your nose, but it has to performed as a medical necessity to be covered. You will have to pay out of pocket for a cosmetic rhinoplasty if you choose to have it done with a septoplasty.
Dr. Andrew Frankel is a world-renowned facial plastic surgeon practicing at the Lasky Clinic since 1994. He is board certified in Facial Plastic and Reconstructive Surgery, as well as Otolaryngology-Head and Neck Surgery. He specializes in revision rhinoplasty and rhinoplasty in Los Angeles, CA. He also specializes in facial plastic surgery and performs facelifts, brow lifts, and neck lifts. Dr. Frankel exclusively performs surgery in the face, head and neck regions.