The question of whether deviated septum surgery is a nose job highlights a common confusion between two distinct surgical procedures: septoplasty and rhinoplasty. These operations, while both concerning the nose, have fundamentally different goals and focus on separate parts of the nasal structure. Septoplasty is a functional, medical procedure designed to correct internal structural issues, whereas rhinoplasty is primarily an aesthetic procedure aimed at modifying the external appearance of the nose.
Septoplasty for Internal Structure Correction
Septoplasty focuses entirely on improving the function of the nasal passages by correcting a deviated septum. The septum is a wall of bone and cartilage dividing the nasal cavity into two nostrils. When crooked or displaced, a deviated septum obstructs airflow, leading to chronic breathing difficulties, congestion, or recurrent sinus issues.
The goal of the surgery is to straighten the septum to allow for better airflow, thereby alleviating these medical symptoms. During the procedure, the surgeon works through incisions typically made inside the nostrils, lifting the protective mucosal lining to access the underlying cartilage and bone. The deviated portions of the septum are then trimmed, repositioned, or sometimes replaced to restore a straight central partition. This internal correction generally does not change the external shape or size of the nose.
Rhinoplasty for External Appearance Modification
Rhinoplasty, commonly known as a “nose job,” is a surgical procedure that primarily focuses on altering the physical appearance of the nose to enhance facial harmony. This operation addresses purely aesthetic concerns, such as the size, shape, and proportion of the nasal structure relative to other facial features.
Surgeons use rhinoplasty techniques to modify various external features, including reducing a dorsal hump (a bump on the bridge), refining a bulbous or droopy nasal tip, or narrowing a wide nasal base. Incisions may be confined to the inside of the nose (closed technique) or involve a small cut across the columella, the strip of tissue between the nostrils (open technique), depending on the extent of reshaping required. While some rhinoplasties can also improve breathing, the driving force behind this surgery is cosmetic change.
Combining Functional and Aesthetic Procedures
In many cases, a patient may suffer from a deviated septum that causes breathing problems while also desiring a change in the appearance of their nose. The combined procedure to address both concerns simultaneously is called a septorhinoplasty. This single operation integrates the functional correction of the septoplasty with the aesthetic modifications of the rhinoplasty.
Performing both procedures at the same time offers the advantage of a single surgical session and one recovery period. The surgeon can coordinate the aesthetic changes with the functional repair to ensure that the external reshaping does not compromise the airflow. For example, the cartilage removed during the septoplasty can often be repurposed as structural grafts during the rhinoplasty portion to strengthen the nasal framework. This combined approach is particularly beneficial when the septal deviation has also caused the nose to appear visibly crooked.
Insurance Coverage and Medical Necessity
A practical distinction between the two procedures lies in how they are covered by health insurance. Septoplasty is considered a medically necessary surgery because it corrects a structural defect that impairs a bodily function, specifically breathing. Therefore, a standalone septoplasty is typically covered by health insurance.
Rhinoplasty, when performed solely to improve appearance, is classified as an elective cosmetic procedure and is generally not covered by insurance. When a septorhinoplasty is performed, insurance will often cover the portion of the surgery related to the functional correction of the deviated septum. The patient is responsible for the fees associated with the cosmetic modifications, including the surgeon’s time for the aesthetic part and sometimes a portion of the facility and anesthesia costs. To secure coverage for the functional part, documentation proving medical necessity, such as objective evidence of airway obstruction, is required.