Most people know rhinoplasty as a cosmetic procedure — a surgery to refine the shape of the nose. Fewer understand that a significant number of rhinoplasty patients have a functional problem in addition to an aesthetic one: a deviated nasal septum that makes breathing difficult, contributes to chronic congestion, or worsens sleep quality.
Septorhinoplasty addresses both in a single operation. It is one of the more technically demanding procedures in facial plastic surgery, because the surgeon must simultaneously address the internal architecture of the nose while achieving a precise cosmetic outcome on the outside. When done by an experienced board-certified surgeon, it produces results that are both functionally meaningful and aesthetically refined.
Here is what patients considering septorhinoplasty in Beverly Hills should understand about the procedure, the recovery, and what to expect.
What Is Septorhinoplasty?
Septorhinoplasty is the combination of two procedures performed together under a single anesthetic:
- Septoplasty — correction of the nasal septum, the internal wall of cartilage and bone that divides the left and right nasal passages. A deviated septum restricts airflow on one or both sides and often causes chronic nasal congestion, mouth breathing, and reduced sleep quality.
- Rhinoplasty — cosmetic reshaping of the external nose, including the bridge (dorsum), the tip, the nostrils, and the overall profile and symmetry.
Performing both in a single surgery is advantageous because both procedures require access to the same internal nasal anatomy. A combined approach means one anesthetic event, one recovery period, and an opportunity to plan the functional and cosmetic outcomes in an integrated way rather than in separate surgeries months apart.
Who Is a Candidate for Septorhinoplasty?
The ideal candidate for septorhinoplasty has both a documented functional concern and cosmetic goals they want to address simultaneously. Common presentations include:
- A deviated septum confirmed on physical examination or imaging, causing documented breathing obstruction
- Chronic nasal congestion that does not respond adequately to medications or sprays
- Cosmetic concerns about the size, shape, or symmetry of the nose
- A nose that appears crooked externally — often because the underlying septal deviation is pulling the external structure off-center
- Post-traumatic changes to the nose following an injury, where both function and appearance were affected
Patients must be in good general health, non-smokers or willing to stop smoking well before and after surgery, and have realistic expectations about the achievable outcome. Nasal skin thickness, cartilage strength, and healing biology all influence the cosmetic result.
A useful way to think about septorhinoplasty: septoplasty corrects what is wrong inside. Rhinoplasty refines what you see outside. When the two are done together by a surgeon experienced in both, the structural correction often improves the cosmetic outcome — and the cosmetic plan can be designed to complement the functional repair.
The Septorhinoplasty Procedure
Anesthesia and Setting
Septorhinoplasty is performed under general anesthesia in an accredited surgical facility. The procedure typically takes two to three hours, depending on the complexity of the functional repair and the scope of the cosmetic changes.
Open vs. Closed Approach
In an open rhinoplasty approach, a small incision is made across the columella (the narrow strip of tissue between the nostrils), allowing the surgeon to lift the skin and work with direct visualization of the nasal cartilage and bone. In a closed approach, all incisions are made inside the nostrils. The open approach is more commonly used for septorhinoplasty because the internal septal repair benefits from the same direct exposure.
Septal Correction
The deviated cartilage and bone are repositioned, scored, or partially removed to straighten the septum and restore normal airflow. In some cases, cartilage harvested from the deviated segment of the septum is preserved for use as grafting material in the rhinoplasty component of the procedure.
Cosmetic Reshaping
Once the septal work is complete, the surgeon addresses the cosmetic goals: reducing a hump on the bridge, refining and repositioning the tip cartilages, improving nostril symmetry, or adjusting projection and rotation. Cartilage grafts — from the septum, the ear, or in some cases a rib — may be used to add structure or support in specific areas.
Closure and Splinting
The incisions are closed with fine sutures, internal silicone splints are placed to support the septum during initial healing, and an external nasal cast is applied to protect the cartilage framework while the nose stabilizes in its new position.
Recovery After Septorhinoplasty
Recovery from septorhinoplasty follows a predictable timeline, though individual variation in swelling and healing rates affects the experience.
| Timeline | What to Expect |
|---|---|
| Days 1–3 | Nasal congestion from internal swelling, mild to moderate bruising around the eyes, minimal pain managed with prescribed medication. Head elevation is important. |
| Days 4–7 | Bruising visible, swelling peaks and begins to improve. Internal splints and external cast in place. No glasses, no blowing nose. |
| Day 7–10 | Cast removed, internal splints removed. Nose appears swollen but the basic shape is visible. Many patients return to work within this window. |
| Weeks 2–4 | Residual bruising fades. Social swelling — the puffiness visible in photos — continues to resolve. Most patients feel comfortable in public. |
| Months 1–3 | Approximately 70 to 80 percent of the cosmetic result is visible. Functional improvement (breathing) is typically appreciated as early as 3 to 4 weeks once internal swelling resolves. |
| Month 12 | Final result. Tip swelling, the slowest to resolve, has fully cleared. Complete cosmetic assessment is accurate at this point. |
Patients should avoid strenuous exercise for four to six weeks, contact sports for three months, and any activity that risks impact to the nose during the early healing period. Sun exposure should be minimized during the first several months, as sunburn on healing tissue can cause prolonged redness.
Insurance and Cost Considerations
Septorhinoplasty is unique among facial plastic surgery procedures in that part of the cost may be covered by health insurance. When a deviated septum causes documented, medically significant breathing obstruction, the functional (septoplasty) portion of the surgery is typically considered medically necessary.
Insurance generally requires:
- Documentation of symptoms (chronic congestion, breathing difficulty, sleep disruption)
- Physical examination finding of a deviated septum
- A trial of conservative treatment such as nasal sprays or antihistamines
- Pre-authorization from the insurer before surgery
The cosmetic rhinoplasty component is not covered and is billed separately. The total out-of-pocket cost in Beverly Hills for the cosmetic portion typically ranges from $7,000 to $13,000 depending on complexity, with the functional portion potentially reimbursed in part by insurance.
All-in costs for septorhinoplasty in Beverly Hills — including surgeon fees, anesthesia, and facility fees — generally range from $9,500 to $18,000 for patients without insurance coverage. Patients with insurance covering the septal portion can expect meaningful reimbursement, though the specific amount depends on their plan, deductible, and out-of-pocket maximum.
Why Beverly Hills for Septorhinoplasty?
Rhinoplasty is among the most technically demanding procedures in all of plastic surgery. The nose is the most central feature of the face, small refinements produce dramatic visual changes, and the margin for error is narrow. The cosmetic outcome is permanent, and revision surgery — while possible — is more complex than the primary procedure.
Beverly Hills attracts surgeons who have built careers around facial procedures, with patient populations that have high cosmetic expectations and the means to seek specialized expertise. The concentration of board-certified plastic surgeons with large rhinoplasty practices means that both patient volume and depth of experience are significant.
For septorhinoplasty specifically, the surgeon's understanding of nasal anatomy and structural support is paramount. Overcorrection of the septum, excessive cartilage removal, or a tip refinement that sacrifices structural integrity can create breathing problems that did not exist before surgery. Choosing a surgeon with demonstrated experience in functional rhinoplasty — not just cosmetic rhinoplasty — is the most important decision a patient makes.
Frequently Asked Questions
Schedule a Consultation with Dr. Newman
Board-certified plastic surgeon Dr. Michael K. Newman, MD, FACS performs septorhinoplasty at his Beverly Hills practice. Schedule a private consultation to discuss your functional and aesthetic goals.
Request a Consultation