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Rhinoplasty can cost between $3,000 and $15,000 depending on your surgeon's reputation and level of expertise, the complexity of your surgery, the geographic location of your surgeon's practice, and many other factors.
Rhinoplasty can enhance the appearance of the nose, improve function, or both. Functional rhinoplasty, which usually involves refining the structure of the nose to improve breathing, may be partially or fully covered by your medical insurance. Surgery performed specifically for aesthetic improvement, however, is an out-of-pocket expense.
For many of us, the cost of plastic surgery is significant, and can often require financing. Because it is a substantial investment, it is important for patients to learn as much as possible about the factors that affect the cost of surgery, and choose an excellent surgeon who is most likely to deliver satisfying results.
Choosing a Qualified Surgeon
Your plastic surgeon's experience and reputation make the greatest difference in the cost of rhinoplasty. Here in Manhattan, it is possible to undergo the procedure for as little as $3,000 when it is performed by surgeons-in-training, supervised by senior surgeons. Meanwhile, there are experienced surgeons who are not performing as many rhinoplasties as they would like, and may be willing to perform the procedure for $5,000 to $7,000. However, if rhinoplasty is your surgeon's specialty, this can provide the best chances of achieving the results you desire. His or her fees will reflect that, and depending on where the practice is located, the total cost of surgery can be upwards of $15,000.
You should plan to invest plenty of time in exploring the credentials of a surgeon to determine if their fees are a justified reflection of his or her skill. Shervin Naderi, M.D. is a surgeon in Washington D.C. who specializes in rhinoplasty, and warns patients against being persuaded by a high-profile public image.
Sometimes, a good reputation is well deserved, and sometimes it's merely hype and marketing
"Sometimes, a good reputation is well deserved, and sometimes it's merely hype and marketing," Dr. Naderi said. "There are reality show plastic surgeons who charge high fees, for example, based on their television exposure and publicity. Then, there are well-known plastic surgeons in the field who focus mainly on nose surgery and are true specialists."
One of the more objective ways to determine whether a surgeon is worth your time and investment is to verify that he or she is certified by:
- The American Board of Facial Plastic and Reconstructive Surgery (ABFPRS)
- The American Board of Otolaryngology (made up of surgeons certified in otolaryngology, or the study of ear, nose, and throat surgery)
- The American Board of Plastic Surgery
Meeting with multiple prospective surgeons is also a great way to make your choice. Make sure you are comfortable speaking to the surgeon, and make sure he or she asks you plenty of questions, and does not rush you through any part of the consultation. After you have fully described your goals, the surgeon should provide you with informative, thoroughly explained options.
"People shouldn't be afraid of asking questions," says Stephen Perkins, M.D., a colleague practicing in Minneapolis. "I encourage them to ask why - to ask what is involved in the price and why it is more or less costly than a surgeon down the street."
Surgical Venue Cost
Rhinoplasty can be performed in one of three places: private surgical suites, ambulatory surgical centers, or hospitals. You should speak with your surgeon and make certain that their chosen venue has been accredited by an organization such as the American Association for Accreditation of Ambulatory Surgical Facilities (AAAA), the Accreditation Association for Ambulatory Health Care (AAAHC), or the Joint Commission for Accreditation of Healthcare Organizations (JCAHO).
Private surgical suites, usually located in the surgeon's office, carry the least expensive facility fees. Usually ranging in cost from $1,000 to $3,000 per procedure, a private surgical facility can offer many advantages. The doctor is very familiar with the facility, and is likely working with the same staff members who have assisted in many previous surgeries. I operate in a certified private surgical facility where my patients enjoy the ultimate privacy and personalized care. In this setting, I am able to hand-pick each of my staff members personally, from nurses to anesthesiologists.
Ambulatory surgical centers are more expensive than private offices. These venues are owned by a third party, and provide everything your surgeon needs to safely perform rhinoplasty and other cosmetic surgery procedures. They typically charge by the hour. Ambulatory surgical center fees are usually around $3,000 or more for a single rhinoplasty procedure.
Hospitals are the most expensive choice of facility. In Manhattan, fees can reach $6,000 and beyond for a single procedure. Though it is the most costly option, a hospital is also the best equipped to facilitate surgery involving a patient who is prone to excessive bleeding, or has other conditions that increase the risk of complications. You can expect your doctor to closely examine your medical history to determine if surgery in a hospital is necessary.
Anesthesia helps you relax during surgery and prevents you from feeling any pain. This relaxed state also makes it easier for your plastic surgeon to work efficiently.
Both anesthesiologists and registered nurse anesthetists can administer anesthesia. An anesthesiologist is a specially trained physician who will administer anesthesia and monitor your vital signs during surgery. A registered nurse anesthetist has specialized training to do the same. However, while a registered nurse's services can cost about $300 per hour, an anesthesiologist's services can cost closer to $500 per hour.
This aspect really comes down to your surgeon's preferences and your own peace of mind. Some surgeons will only work with a certified anesthesiologist. Meanwhile, some patients feel more comfortable with an anesthesiologist.
Extent of Treatment
The extent and complexity of treatment can also increase the cost of rhinoplasty. In short, a complex procedure takes more time, and is therefore more expensive than a simpler procedure. Factors that make surgery more complex include:
- Having experienced multiple nasal injuries
- A need for cartilage grafts to reinforce weak areas
- Having very thick or thin skin
- Nasal obstruction
- Severe nasal deviations
The geographic location of the surgeon's practice can greatly affect the cost of rhinoplasty. More affluent cities and neighborhoods, such as Manhattan and Los Angeles, are plastic surgery hubs where some of the best surgeons in the world practice. Meanwhile, these areas also have a higher cost of living, which means higher overhead costs (rent, staff wages, utilities), and that translates to a higher overall price of rhinoplasty.
Hospital surgery standards and the accredited and certification agencies that evaluate facilities and surgeons are rigid. While you may find more surgeons in more populous cities, there are quality surgeons in every part of the country, and often at a lower cost.
However, American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) President Stephen Park, M.D., explains that if you want to get the most value for your investment in rhinoplasty, it's not as simple as driving to a smaller city.
"Many times, the cost of rhinoplasty or other surgery in New York City would be three times the price as in a smaller town, but it is not three times better necessarily," Dr. Park said. "At the same time, I would warn patients to beware of a physician in a small town that costs a fraction of what an average rhinoplasty would cost. In general, when a surgeon is throwing in discounts, I would be very wary."
In recent years, medical tourism, or going outside the U.S. for a surgery or procedure, has become more popular. Patients go to other countries to have rhinoplasty and other surgery performed at a lower cost. While several other countries, such as South Korea, Columbia, and Italy, may have surgeons willing to perform rhinoplasty at a low cost, the quality and safety standards may not be as closely regulated as they are in the U.S.
One of the main things to keep in mind regarding medical tourism is how difficult it may be to see or even contact your doctor after surgery. Follow-up appointments are extremely important. When surgery is performed internationally, patients either miss post-operative appointments or have to stay in the area for an extended period of time. When you have surgery closer to home, you can more easily attend these appointments and visit your surgeon if any other problems or concerns arise. Many surgeons like myself will revise their own work at no additional charge except for anesthesia fees or surgical venue fees.
Revision surgery performed by a different surgeon is extremely difficult, and thus more expensive
However, if a patient underwent surgery in another country, but experiences post-operative complications, he or she will need to pay to travel back to the same destination if they wish to have the same doctor oversee any revisions. Revision surgery performed by a different surgeon is extremely difficult, and thus more expensive. In fact, it can cost 50 percent more than the original surgery. Therefore, it can actually be far more economical to pay for a surgery within the U.S.
Pre- and Post-operative Costs
Because they are an essential part of a successful rhinoplasty, you should plan for pre- and post-operative appointments in addition to your surgery itself. You should fully understand the cost of your initial consultations, preparatory appointments and follow-up appointments when considering the cost of rhinoplasty.
After surgery, patients should be prepared for the cost of any pain medication they will take during recovery. These costs are not typically included in the overall cost of surgery. At my practice, we provide homeopathic medications as part of our total surgical package. Your surgeon can explain to you any prescription or homeopathic medications you may be prescribed and discuss their cost.
For my patients, I also provide a post-operative packet. This includes arnica and other ointments, gauze and tape, an ice pack, and nasal decongestant spray. If your surgeon does not provide these items to you before or after your surgery, they are all helpful during the healing process. I encourage my patients to get anti-nausea medication for the first few days following surgery as well.
Dr. Park explains that you should expect your surgeon to explain potential post-operative costs that you may incur after surgery.
"A patient should be aware if those sorts of things are going to be reimbursed or covered in overall cost," Dr. Park said. "Usually, post-operative costs will be included in the cost, but a patient should know beforehand."
Additional Costs to Consider
Many of my patients have experienced increased acne breakouts in the three to four months following rhinoplasty. I highly recommend that patients receive facials and use high-quality skin care products. Facials can cost from $100 to $200. Your surgeon can supply or recommend appropriate face wash and moisturiser to help reduce any acne breakouts.
Post-inflammatory hyperpigmentation, or darkening of the skin, can also occur after surgery. Hyperpigmentation naturally fades with time after swelling has gone down. To expedite the reduction of hyperpigmentation, patients can undergo laser treatments to even skin tone, which can cost between $2,000 and $3,000.
There are some other indirect costs associated with rhinoplasty, including any lost wages from the time you will need to take off of work for surgery and recovery. If traveling for surgery, you should consider the cost of gasoline, flights, hotel rooms, and any other travel expenses.
Medical insurance will usually cover the cost of what is known as a functional rhinoplasty. Some patients have the option of using a health care savings account as payment. A functional rhinoplasty is performed to improve patients' breathing. Conditions that can be treated with rhinoplasty include:
- Nasal vestibular stenosis, in which the nasal side walls begin to collapse inward, obstructing the airway. A functional rhinoplasty can stabilize the side walls of the nostril to allow patients to breathe easier.
- Large inferior turbinate requiring the removal of some tissue from the inferior turbinates, which are on either side of the nostrils. The turbinates clean air as it moves through the nose. When they are too large, they can cause airway resistance. Your surgeon can reduce their size while still preserving their essential function.
- Nasal fractures
- Deviated nasal septum, in which the septum of the nose has shifted to one side of the nasal airway or another and can obstruct breathing.
To apply for insurance coverage for a functional rhinoplasty, your surgeon can perform one of several tests. A CT scan shows irregularities within the nose that are not visible to the naked eye. An acoustic rhinometry is a test that maps the inside of a patient's nose. A rhinomanometry tests the level of airflow within the nostrils. In some cases, insurance companies require that patients show that they have attempted to treat nasal obstruction with other treatments. These may include antihistamines, allergy desensitizing injections, and steroid spray.
Financing Cosmetic Rhinoplasty
Most plastic surgeons offer some type of financing, either through an outside provider or through an in-house financing program.
For patients who have undergone facial trauma from domestic violence or from serving in the armed forces, a pro bono service is available to help. The American Academy of Facial Plastic and Reconstructive Surgery, has created the FACE TO FACE program, which provides funding for a variety of facial injuries, including nasal trauma.
I recently performed a revision rhinoplasty for Jane, who had undergone a rhinoplasty procedure several years ago while living abroad.
"Many years later, I realized I wasn't breathing well, and I never really liked the way it looked," she said. "When I decided to have another surgery, I wanted to make sure that no matter what happened, I wasn't going to be worse off, and that the damage done before was going to be corrected."
Jane scheduled consultations with several doctors, including me.
"In talking to Dr. Constantinides, I expected the fees were going to be high, but I didn't feel as connected to the other doctors," she said. "I thought his estimate was reasonable, and I was like, ‘Hey, I'm getting the best I can get, and it's going to change my life, it's going to change how I breathe, and he is highly recommended.'"
I think the follow-up appointments are as important as the initial consultations and the surgery
Today, Jane is enjoying a refined nose shape that not only allows her to breathe properly, but also achieves the aesthetic goals she had originally envisioned. Meanwhile, she said, she learned a valuable lesson about the importance of being able to meet face-to-face with your surgeon following rhinoplasty.
"I think the follow-up appointments are as important as the initial consultations and the surgery," she said.
Your nose is one of your most prominent features. If you are dissatisfied with the shape of your nose, and wish to refine it with cosmetic surgery, you should be prepared to define your goals, determine the surest way to achieve those goals, and make no compromises in your pursuit of the results you desire. Meet with several reputable and credentialed surgeons, ask questions, and make your choice based on the surgeon's ability to listen and educate, as well as his or her track record of providing beautiful results.
Meanwhile, remember that cutting corners in the interest of saving money can actually cost you significantly more than a procedure performed to your exact specifications the first time around. As my colleague Dr. Naderi put it: "Cost is only a part of the story. Bargain shop for your shoes, but not for your face."
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