According to the American Society of Plastic Surgeons, the largest organization of board-certified plastic surgeons in the world, rhinoplasty remains one of the top cosmetic plastic surgery procedures performed yearly in the United States. Well over 200,000 Americans undergo rhinoplasty (also called a nose job) every year. While this operation may be performed for purely aesthetic or cosmetic reasons, I see many prospective rhinoplasty patients from the San Diego area who also complain of nasal airway obstruction and difficulty breathing through one or both nostrils. Most patients have disliked the appearance of their nose for many years. For others, prior nasal trauma from an accident may have unfavorably changed the shape and appearance of the nose.
What’s the difference between primary and secondary rhinoplasty?
Rhinoplasty is also classified based upon the patient’s prior surgical history. Primary rhinoplasty indicates this is the first time a patient has undergone this procedure. Secondary rhinoplasty indicates the patient has previously undergone rhinoplasty; this is technically considered a revision rhinoplasty. On rare occasions, patients have undergone multiple prior rhinoplasties yet are still considered revision rhinoplasty cases.
How is the cost for a rhinoplasty procedure calculated?
The costs associated with rhinoplasty are made up of the following fees:
- The surgeon charges a fee for the actual procedure, which generally includes all preoperative and postoperative care.
- The outpatient surgery center or hospital charges a facility fee which includes use of the operating room, operating room personnel, surgical equipment, and recovery room.
- There is a separate charge for anesthesia care, which is usually administered by an anesthesiologist or nurse anesthetist. This fee is charged at an hourly rate which also includes care in the recovery room by the anesthesia team.
How do you estimate the surgeon’s fees?
When patients are seen in my La Jolla practice for a rhinoplasty consultation, my consultant provides a detailed quote of the costs associated with rhinoplasty. It is important that patients understand the surgical quote is an estimate of the time it will take to perform surgery. Since I have been doing this operation for over 3 decades, I have become very proficient at estimating how long surgery will take. However, each patient and each case is different, so the surgical quote varies with a variety of factors, including:
- The complexity of the case
- Whether the patient has had prior surgery
- The need for additional tissue like cartilage or fascia
- The patient’s response to surgery including intraoperative bleeding and response to anesthesia
I always tell my prospective rhinoplasty patients that they have my undivided attention during surgery. I am hyper focused on the operation itself and the final outcome. While the estimate for the time surgery will take is just that, an approximation, I pledge to remain in the operating room until all their aesthetic goals are met. It’s the same focus an artist brings to a work of art. We will not leave until I feel the result cannot be made any better.
What makes primary rhinoplasty cost more than revision rhinoplasty?
The cost of primary rhinoplasty is generally less than the cost of secondary (or tertiary) rhinoplasty, called revision rhinoplasty, because primary rhinoplasty is typically more straightforward. The increased complexity of revision procedures is typically due to:
- More scar tissue and subsequent bleeding
- The need to harvest additional tissue like cartilage and fascia to reconstruct or repair the deformities caused by the initial rhinoplasty
Does the surgeon’s experience factor into the cost?
The cost of primary and secondary rhinoplasty is higher for very experienced rhinoplasty surgeons. Experienced surgeons have a much lower revision rates and may actually be more cost-effective for rhinoplasty patients than surgeons who only occasionally perform rhinoplasty. This is especially true for revision rhinoplasty, which is arguably one of the most challenging cosmetic plastic surgery procedures.
What is the typical cost for rhinoplasty by an experienced plastic surgeon?
The cost of primary rhinoplasty with experienced plastic surgeons varies from $10,000 to $15,000 depending on the region of the country. Some primary rhinoplasty cases are inherently more difficult and occasionally require the use of the patient’s own tissue like cartilage and fascia to obtain the best aesthetic outcome.
Revision rhinoplasty tends to be more expensive than primary rhinoplasty partly because of the extended operative time, which increases both the outpatient surgery costs and anesthesia charges. Total costs vary from $15,000 and upwards.
Does insurance cover rhinoplasty procedures?
Some of the costs associated with rhinoplasty may be offset by a patient’s insurance company. However, it is important to remember that most highly experienced and successful plastic surgeons who are experts in rhinoplasty do not accept insurance because they are not on any insurance plans. Their practices have matured over the years, and the patient demands for their services exceed any reimbursement by insurance companies. It is simply not possible to provide the individual care patients deserve if you are working for an insurance company that is profit based and often denies coverage for medically necessary surgery. Our practice philosophy is to provide patients with the necessary insurance codes for rhinoplasty as a complimentary service. Patients are free to appeal to their insurance companies for any reimbursement of medically indicated portions of rhinoplasty. However, this is often not very successful despite our best efforts as our patients’ advocates.
What is most important to look for when choosing a rhinoplasty surgeon?
In conclusion, patients who seek rhinoplasty should choose their plastic surgeon based upon credentials and operative experience. There is a familiar saying in surgery: “Judgement comes from experience and experience comes from bad judgement!” As with any cosmetic surgery, do not shop price or look for a “bargain”. What you may save upfront may be far more expensive in the long run, especially if revision rhinoplasty is necessary. My experience as a board-certified Otolaryngologist-Head & Neck Surgeon, board-certified Facial Plastic Surgeon, and board-certified Plastic Surgeon provides a wealth of knowledge, training, and credentials in both primary and revision rhinoplasty to correct functional deformities while creating an aesthetically appealing and natural appearing nose. We are often the referral source for patients considering rhinoplasty by other board-certified plastic surgeons in San Diego County and adjacent areas.