Septorhinoplasty is a single operation that combines septoplasty (straightening a deviated septum to improve breathing) with rhinoplasty (reshaping the external nose). It is performed under general anaesthetic in 2 to 4 hours, typically as day surgery. When the septoplasty component meets Medicare item 41671 criteria, a partial Medicare rebate may apply to the functional portion of the procedure; the cosmetic rhinoplasty component is not Medicare-eligible. Dr Peter Laniewski (FRACS, AHPRA MED0001155003) performs septorhinoplasty in accredited private hospitals in Sydney, the Central Coast and Albury.
For many patients, the combination makes practical and financial sense. Addressing the septum and the external nose in one procedure means a single anaesthetic, a single recovery period, and the opportunity to plan the airway and appearance together. This page explains how septorhinoplasty works, who it suits, and what you need to know about Medicare eligibility before your consultation. If you are ready to take the next step, contact our team to arrange your assessment.
What Is Septorhinoplasty?
Septorhinoplasty is the surgical term for a combined procedure that corrects the internal structure of the nose and reshapes its external appearance at the same time. The ‘septo’ refers to the septoplasty component (work on the nasal septum), and the ‘rhinoplasty’ refers to the cosmetic reshaping. Together, they form a single, integrated operation rather than two separate surgeries performed back-to-back.
The septum is the upright wall of cartilage and bone that splits the nose into a left and a right passage. A deviated septum, whether it is present from birth, follows an undiagnosed knock in childhood, or results from a later injury, can narrow one or both passages and make breathing through the nose hard or, at times, impossible. Left as it is, that deviation can also lead to ongoing nasal congestion, broken sleep, mouth breathing, and repeated bouts of sinusitis.
The cosmetic component, the rhinoplasty, addresses whatever the patient wants changed about the external shape of their nose: a prominent dorsal hump, an asymmetric tip, overly wide nostrils, or the visible crookedness that often accompanies a deviated septum. Correcting the internal deviation without also correcting the external crookedness would leave half the problem unresolved for many patients. Combining both components into a single procedure is the integrated approach. See Dr Laniewski’s full rhinoplasty page for more details on what cosmetic nose surgery can address.
The single-procedure approach also has a structural planning advantage. The surgeon can assess and modify the septum, harvest septal cartilage for grafts as needed, and design the external result in light of the new internal architecture, all in a single session. Doing these steps separately, at different points in time, makes that kind of integrated planning impossible.
Septoplasty vs Rhinoplasty: What Is the Difference?
Septoplasty corrects the internal cartilage wall (the septum) inside the nose to improve breathing, with no change to the external appearance. Rhinoplasty reshapes the external nose, its bone, cartilage and soft tissue. Septorhinoplasty combines the two in one operation.
Here is a quick side-by-side comparison of the three procedures.
| Septoplasty | Rhinoplasty | Septorhinoplasty | |
|---|---|---|---|
| What it corrects | Internal nasal septum (cartilage and/or bone dividing the two nasal passages) | External nose shape: tip, bridge, nostrils, width | Both: internal airway and external nose shape in one procedure |
| Changes appearance? | No | Yes | Yes |
| Medicare item | Item 41671 (when NOSE criteria met) and related items | Not eligible (cosmetic) | Item 41671 may apply to the functional component; cosmetic portion is not Medicare-eligible |
| Anaesthetic | General anaesthetic (or sometimes local with sedation) | General anaesthetic | General anaesthetic |
| Recovery | 1-2 weeks from work; internal swelling resolves over 4-8 weeks | 1-2 weeks from work; final shape at 12 months | 1-2 weeks from work; breathing improvement often apparent by 6-8 weeks; final shape at 12 months |
Patients are sometimes told by a GP or ENT that they need a ‘septoplasty’ and then separately research nose reshaping. Septorhinoplasty simply recognises that both needs can be addressed together when the patient wants and the anatomy allows.
Who Is a Candidate for Septorhinoplasty?
The most straightforward candidates are patients who have both a documented breathing problem and a cosmetic concern they want to address at the same time. In practice, these situations tend to group into a few recognisable patterns.
Deviated septum with cosmetic concerns
A patient who has been living with a deviated septum for years, breathing through their mouth at night and waking with congestion, and who has also always been unhappy with the shape of their nose, is the archetypal septorhinoplasty candidate. Both problems exist independently, and both are resolved in one operation.
Post-traumatic nasal deformity
A broken nose that was not surgically reduced at the time of injury frequently results in both internal deviation and external crookedness. The patient may have reduced airflow through the affected side and a visibly crooked nasal bridge. Septorhinoplasty addresses the full structural consequences of the injury in a single procedure, and this patient category is typically well supported by Medicare item eligibility.
Congenital or developmental deformity
Some patients have a nasal shape or internal anatomy that did not develop typically. This group also has potential access to Medicare rebates for the functional component, subject to meeting the clinical criteria.
Prior rhinoplasty with airway compromise
Patients who have had a previous rhinoplasty that resulted in breathing difficulties, whether due to scarring, over-resection of cartilage, or nasal valve collapse, may require revision septorhinoplasty. These cases are more technically demanding and are assessed individually at consultation.
Medicare NOSE Scale screening
For Medicare item 41671 to apply, the patient’s nasal obstruction symptoms must meet a defined clinical threshold. The NOSE Scale (Nasal Obstruction Symptom Evaluation) is the validated questionnaire Medicare references as part of the eligibility assessment. A score above 45 on this scale is one of the benchmarks for eligibility. Patients who suspect they may qualify are encouraged to discuss their breathing symptoms in full at their GP appointment before referral, as the clinical documentation at that stage is important for item eligibility.
Is Septorhinoplasty Covered by Medicare?
A partial Medicare rebate may apply to the septoplasty component of septorhinoplasty under MBS item 41671 when specific clinical criteria are met. The cosmetic rhinoplasty component is not Medicare-eligible.
Knowing how the Medicare part actually works makes it easier to budget realistically ahead of your consultation.
Item 41671: septoplasty
Item 41671 applies to septoplasty performed for clinically significant nasal obstruction. A rebate is only possible where the obstruction is assessed as causing genuine functional impairment. The NOSE Scale serves as one reference point here, and a score above 45 is among the benchmarks considered alongside what the clinical examination shows. To meet the item, a patient needs either a significant acquired, congenital or developmental nasal deformity that contributes to the obstruction, or a NOSE Scale result that reaches the threshold.
Items 45632, 45635, 45641, 45644 and 45650
Additional functional rhinoplasty items exist for more extensive surgical work on the nasal airway. Items 45632 and 45635 cover partial rhinoplasty for functional reasons. Items 45641 and 45644 cover total rhinoplasty for post-traumatic or congenital deformity. Item 45650 applies to revision functional rhinoplasty in specific circumstances. It is worth noting that a 2018 change to the MBS tightened the rules around revision septoplasty in patients who had previously undergone purely cosmetic rhinoplasty. Whether any of these items apply in a given case is determined at consultation based on clinical documentation, not patient preference.
What Medicare does not cover
The cosmetic portion of the procedure, any reshaping of the external nose for aesthetic reasons, is not covered by Medicare, regardless of whether functional work is being performed at the same time. Medicare separates the two components, and the rebate, when it applies, is calculated on the functional portion only.
Eligibility is determined clinically
After your assessment, Dr Laniewski’s team will determine which item numbers apply and provide you with an itemised written quote that breaks down the functional and cosmetic portions, so you can decide before proceeding. This page should not be treated as the final word on Medicare eligibility. MBS criteria do change from time to time, and what you read here reflects the schedule as of the last review date. The real answer comes from your GP referral and the clinical assessment at your consultation.
Medicare item details are published on MBS Online. Last reviewed: 26/6/2026.
What About Private Health Insurance?
When a Medicare item number applies to the functional component of your septorhinoplasty, eligible private health insurance may also contribute to the hospital and theatre fees, subject to your level of cover and any waiting periods. Major Australian funds, including Bupa, NIB, Medibank, HCF, Australian Unity, Allianz Care, and others, may contribute under appropriate hospital cover.
A health fund contributes towards the hospital admission costs rather than the surgeon’s fee itself. How much your policy covers, if anything, comes down to your fund and the level of hospital cover you have taken out. Your fund’s member services team is the best place to check this before you book surgery. Once your surgical plan is confirmed, Dr Laniewski’s rooms can also help with the relevant item numbers.
How Is Septorhinoplasty Performed?
Septorhinoplasty is performed under general anaesthetic in a fully accredited private hospital. Most cases run for two to four hours, depending on the complexity of both the functional and cosmetic components. Most patients are discharged the same day or the following morning.
The septoplasty component
The septoplasty is typically performed first. The surgeon makes a small incision inside the nose to access the septum beneath its mucosal lining. The deviated sections of cartilage and bone are carefully repositioned or removed to open the nasal passages. Where septal cartilage is harvested during this step, it can be reshaped and used as a graft to support or refine the external nose during the rhinoplasty component. This use of the patient’s own tissue, called an autologous graft, is one of the structural advantages of combining both procedures in a single operation.
The rhinoplasty component
After the internal work is done, attention turns to reshaping the outside of the nose. Dr Laniewski chooses an open or a closed approach according to how complex the cosmetic goals are. The open technique uses a small incision across the columella and tends to suit detailed tip work or structural grafting. The closed technique keeps every incision inside the nostrils. To see how the two compare, read the open vs closed rhinoplasty guide.
The bone, cartilage and soft tissue of the nose are then adjusted according to the surgical plan agreed at consultation. Where cartilage from the septum has been harvested, it may be used to reinforce the nasal tip, rebuild the bridge, or support the nasal valve.
Splints and dressings
At the end of the procedure, internal silicone splints are often placed against the septum to hold it in position during the early healing phase and to help prevent postoperative adhesions. An external splint is applied over the nose to support the reshaped cartilage and bone. Both are removed at the day 7 review with Dr Laniewski.
Recovery After Septorhinoplasty
Recovery from septorhinoplasty follows broadly the same timeline as recovery from rhinoplasty performed on its own. Most patients return to desk-based work within 1 to 2 weeks, resume light exercise at 3 to 4 weeks, return to full cardiovascular activity at 6 weeks, and avoid contact sports for at least 3 months. The final external shape settles at 12 months. For a full week-by-week breakdown of the recovery milestones, see the rhinoplasty page.
There are a few aspects of septorhinoplasty recovery that are specific to the combined procedure. First, internal nasal congestion tends to be more pronounced in the first 7 to 10 days compared with a purely cosmetic rhinoplasty, because the additional internal work on the septum creates more internal swelling. Breathing through the nose may initially feel more blocked, not less, in those first days. This is normal and resolves as the swelling settles.
Second, the silicone splints sitting against the septum add to that blocked feeling during the first week. They come out at day 7, and most people notice their nasal airflow improves straight away, although the full breathing benefit usually does not show until the internal swelling has settled at roughly 6 to 8 weeks.
Third, the everyday post-rhinoplasty precautions are still worth following: keep your head raised when you sleep, steer clear of bending forward or lifting more than 2 to 3 kg in that first week, leave your nose alone rather than blowing it, and rest cold compresses on your cheeks instead of directly on the nose. For more on easing swelling as you heal, see the blog post on reducing swelling after rhinoplasty.
How Much Does Septorhinoplasty Cost in Sydney?
Septorhinoplasty in Sydney with Dr Laniewski is subject to the complexity of the surgical plan, hospital and theatre fees, and the anaesthetist’s fee. Dr Laniewski should be able to confirm the exact price after the initial consultations.
The overall fee reflects several components: the surgeon’s fee (which covers both the functional and cosmetic work), the anaesthetist’s fee, hospital and theatre costs, and follow-up appointments. When Medicare item 41671 applies to the septoplasty component, the Medicare rebate reduces the patient’s out-of-pocket cost on the functional portion. Where the patient holds eligible private health insurance with appropriate hospital cover, the fund may also contribute to the hospital admission costs.
The degree of cost offset from Medicare and health insurance varies from patient to patient and depends on the specific item numbers that apply, the patient’s fund and level of cover, and any applicable benefit limits or gap fees. Dr Laniewski’s team provides a fully itemised written quote after consultation, once the surgical plan is established and any applicable item numbers have been identified.
How Dr Laniewski Approaches Septorhinoplasty
Dr Peter Laniewski practises as a Specialist Plastic Surgeon (FRACS, AHPRA MED0001155003) with over 20 years of surgical experience. He performs both functional and cosmetic nasal surgery at accredited private hospitals in Bella Vista, Woollahra, Erina (Central Coast), Narellan and Albury.
At your first consultation, Dr Laniewski examines both the internal airway and the external nose. The internal assessment includes direct visualisation of the septum and airway, along with the NOSE Scale questionnaire to document the degree of functional impairment. External assessment involves photographic documentation and a detailed discussion of your cosmetic goals. Together, these inform the surgical plan and determine which Medicare item numbers, if any, apply.
Under current AHPRA cosmetic surgery guidelines, septorhinoplasty that includes a cosmetic component requires a GP referral, two consultations, body image (BDD) screening, and a minimum 7-day cooling-off period before surgery is booked. If your surgery is purely functional with no cosmetic change to the external appearance, the AHPRA cosmetic surgery guidelines do not apply; the standard surgical referral process applies instead. Dr Laniewski’s team will clarify which pathway applies to your case at the initial consultation.
To book a consultation, call 1300 322 337 or contact us online.
Why Choose Dr Laniewski for Septorhinoplasty in Sydney and Central Coast
Dr Peter Laniewski practises as a Specialist Plastic Surgeon (FRACS, AHPRA MED0001155003) with over 20 years of surgical training and practice across Sydney, the Central Coast and regional New South Wales. He performs both cosmetic and functional rhinoplasty in fully accredited private hospitals and is recognised by Australia’s three peak plastic surgery bodies.
- FRACS, Specialist Plastic Surgeon. Admitted as a Fellow of the Royal Australasian College of Surgeons. AHPRA registration MED0001155003, verifiable on the public AHPRA register.
- Member of three peak bodies. Australian Society of Plastic Surgeons (ASPS), Australasian Society of Aesthetic Plastic Surgeons (ASAPS), and Board Certified Plastic Surgeons of Australia.
- Over 20 years of surgical experience. Undergraduate medicine at the University of New South Wales, advanced training in General Surgery and Plastic and Reconstructive Surgery, and an international fellowship at the Royal Marsden Hospital in London.
- Sub-specialty training in facial and aesthetic surgery. Further training in Harley Street (London), New York, Germany and France, with a focus on facial and breast aesthetics.
- Operates in accredited private hospitals. All septorhinoplasty surgery is performed in fully accredited private hospital theatres in Sydney, the Central Coast and Albury, under the supervision of specialist anaesthetists.
- Five consultation locations across NSW. Bella Vista (Sydney North-West), Woollahra (Sydney Eastern Suburbs), Erina (Central Coast), Narellan (Sydney South-West), and Albury (regional NSW / Victorian border).
- AHPRA-compliant cosmetic surgery process. All patients receive a GP referral, two consultations, body image (BDD) screening, and a minimum 7-day cooling-off period before surgery is booked, in line with current AHPRA cosmetic surgery guidelines (where the cosmetic component applies).
To verify Dr Laniewski’s specialist registration, search ‘Peter Laniewski’ or registration MED0001155003 on the AHPRA Register of Practitioners. To book a septorhinoplasty consultation, call 1300 322 337 or use the online enquiry form.
Surgeon profile: Dr Peter Laniewski on ASAPS | Dr Peter Laniewski on ASPS | Board Certified Plastic Surgeons of Australia
Frequently Asked Questions
Is septorhinoplasty more expensive than rhinoplasty alone?
It can be, depending on the complexity of the functional work. However, when Medicare item 41671 applies, and eligible private health insurance contributes to hospital costs, the effective out-of-pocket cost for a combined procedure is sometimes comparable to, or lower than, a purely cosmetic rhinoplasty performed without any Medicare contribution. The written quote after consultation will show you the full cost breakdown and any applicable offsets.
Can septorhinoplasty be done as a closed procedure?
Yes, in some cases. The septoplasty component is always performed through internal incisions regardless of the approach used for the external reshaping. Whether the rhinoplasty component is carried out as open or closed rhinoplasty depends on the nature and extent of the cosmetic goals. Dr Laniewski will discuss this at the consultation based on your anatomy and what you want to achieve.
Will I need to stay overnight in the hospital?
Septorhinoplasty is most commonly performed as day surgery, meaning you go home the same day once you have recovered from the anaesthetic and been assessed as safe to discharge. Depending on the complexity of the procedure or individual patient factors, an overnight stay may occasionally be recommended. Your surgical plan will clarify this in advance.
How soon will my breathing improve?
The internal silicone splints are removed at your day 7 review, and most patients notice an immediate improvement in nasal airflow at that point. However, full breathing benefit is generally not apparent until the internal swelling from the septoplasty has fully resolved, which typically takes 6 to 8 weeks. Some patients notice gradual further improvement over the following months as deeper tissue swelling continues to settle.
Do I need a separate referral for the cosmetic part?
No. A single GP referral that addresses your breathing concern is the starting point for the consultation process. The cosmetic goals are discussed at your surgical consultations with Dr Laniewski. You do not need separate referrals for the functional and cosmetic components.
Page authored and clinically reviewed by Dr Peter Laniewski, MBBS FRACS, Specialist Plastic Surgeon. AHPRA registration MED0001155003. Last clinically reviewed: 29/6/2026. The Medicare section of this page reflects MBS criteria as at the review date; eligibility criteria can change and should be confirmed with your GP and surgical team.
This page is for general information and does not replace a face-to-face consultation. All surgical procedures carry risks. For a personalised assessment, book a consultation with Dr Laniewski.
Further Reading
Rhinoplasty (Nose Job Surgery) Sydney – Dr Laniewski’s complete rhinoplasty procedure page, including costs, candidacy, technique overview and before-and-after photos.
Open vs Closed Rhinoplasty: Which Is Right for You? – A guide to how the two surgical approaches compare and how the technique decision is made.
Rhinoplasty Recovery: How to Reduce Swelling After Your Nose Surgery – Practical guidance on managing swelling and supporting healing during nose surgery recovery.
Can Rhinoplasty Help With My Breathing Difficulties? – An overview of how functional rhinoplasty can address nasal obstruction alongside cosmetic reshaping.
Medical References
Medicare Benefits Schedule, Item 41671 (Septoplasty). Australian Government Department of Health. MBS Online.
Stewart MG et al. (2004). Development and validation of the Nasal Obstruction Symptom Evaluation (NOSE) scale. Otolaryngology Head and Neck Surgery. 130(2):157-63. PubMed.
Australian Health Practitioner Regulation Agency (AHPRA). Cosmetic surgery guidelines (effective 1 July 2023). ahpra.gov.au.
Healthdirect Australia. Rhinoplasty (nose job). healthdirect.gov.au.
Cleveland Clinic. Rhinoplasty (Nose Job): What It Is, Recovery and Results. my.clevelandclinic.org.
Cleveland Clinic. Septoplasty: What It Is, Procedure Details and Recovery. my.clevelandclinic.org.
