Septorhinoplasty

Septorhinoplasty is the combination of septoplasty — surgical correction of a deviated nasal septum — with rhinoplasty — reshaping of the external nose. It is one of the most commonly performed nasal procedures in ENT practice, because the septum and the external nose are anatomically interdependent: they share structural components, the same surgical access, and the same cartilage supply. For many patients presenting with both a breathing problem and a cosmetic concern, or with a visibly crooked nose that results from septal deviation, the most logical and efficient approach is to address both in a single operation.

Septorhinoplasty may also attract Medicare and private health insurance rebates for the functional (septoplasty) component of the procedure where the applicable MBS criteria are met. The cosmetic rhinoplasty component is not covered by Medicare.

All surgery carries risks — read the full rhinoplasty risks page →

Why Septoplasty and Rhinoplasty Are So Often Combined

There are several compelling reasons to address the septum and the external nose simultaneously rather than in staged procedures:

Structural interdependence

The nasal septum is not merely a partition — it is the central structural pillar of the nose. The dorsal septum forms part of the nasal bridge. The caudal septum determines the position, projection, and rotation of the nasal tip. The anterior septal angle sits at the keystone of the tip-columella complex. Any change to the septum — whether corrective (straightening a deviation) or reconstructive (repositioning a dislocated caudal septum) — necessarily affects the external appearance of the nose. Performing septoplasty without simultaneously addressing the cosmetic implications of those changes means that a second rhinoplasty operation is often required later.

The septum as cartilage donor

The nasal septum is the preferred source of cartilage grafts for rhinoplasty — the straightest, strongest, and most abundant cartilage conveniently accessible within the same surgical field. Structural rhinoplasty uses septal cartilage for columellar strut grafts, spreader grafts, alar batten grafts, tip grafts, and dorsal onlay grafts. Once a prior septoplasty has removed septal cartilage without preservation for future use, the graft options for a subsequent rhinoplasty are significantly restricted — potentially requiring harvest of ear cartilage or rib cartilage with their attendant additional surgical sites. Performing septorhinoplasty as a combined procedure ensures that the septal cartilage is used efficiently and productively from the outset.

The crooked nose

A nose that is visibly deviated from the midline — crooked to one side — almost always has both a bony component (deviated nasal bones) and a cartilaginous septal component. Correcting only the bony deviation with osteotomies without simultaneously addressing the underlying septal deviation will produce an incomplete correction. Genuine midline correction of a crooked nose requires integrated management of both the external framework and the internal septum — this is septorhinoplasty by definition, even if the patient’s primary concern was purely cosmetic.

Medicare and insurance rebates

Where the septoplasty component meets the MBS criteria for documented nasal airflow obstruction, Medicare and private health insurance contribute to the costs of the functional portion of the procedure. This can substantially reduce the total out-of-pocket expense compared with a cosmetic rhinoplasty alone, and provides a financial incentive to combine the procedures when both are indicated. Dr Roth’s team will assess eligibility at consultation and provide a detailed itemised quote.

Who Is Septorhinoplasty For?

The Procedure

Septorhinoplasty is performed under general anaesthesia. Operating time ranges from two to four hours depending on the complexity of both the septal and cosmetic components. The surgical approach (open or closed rhinoplasty combined with intranasally placed septal incisions) is planned in advance based on the specific requirements of each case.

The order of surgical steps is carefully sequenced. The septum is typically addressed first — straightened, repositioned, and cartilage harvested for grafts — because the septal corrections affect the structural foundation onto which the rhinoplasty is built. The rhinoplasty then proceeds with full access to septal graft material and an accurate understanding of the corrected septal position.

Septorhinoplasty recovery follows the same timeline as rhinoplasty — splint removal at approximately one week, social recovery by ten to fourteen days, return to exercise at four to six weeks, and final result at twelve to eighteen months. Nasal breathing improves progressively as post-operative swelling resolves, typically reaching its final quality by three to six months.

Medicare and Cost

The septoplasty component of a septorhinoplasty is eligible for Medicare and private health insurance rebates where the nasal airflow obstruction meets the applicable MBS item number criteria (principally item numbers 41671, 41672). The rhinoplasty component is not eligible for Medicare rebates where it is performed for cosmetic purposes. In a combined procedure, the surgical fee, anaesthetic fee, and hospital fee are itemised to clearly separate the functional and cosmetic components, and the applicable rebates are applied to the functional component.

The net out-of-pocket cost of septorhinoplasty is typically lower than the cost of a cosmetic-only rhinoplasty of equivalent scope, because the functional rebates offset a portion of the total expense. Dr Roth’s team will provide a detailed itemised quote following consultation.

Two consultations are required before any rhinoplasty proceeds. Contact us to arrange a consultation → | Rhinoplasty Surgery → | Septoplasty → | Rhinoplasty Risks →