To ask if it's possible to have my nose fixed through the NHS?

[PLBV]

My nose was broken by my ex partner some years ago but he wouldn't let me go to the hospital at the time so I wasn't able to have it reset. The result is my nose is very crooked and feels blocked 24-7.

It was big anyway which I've always been insecure about but was happy to live with, but now it's very bent and it looks 10x worse. I hate the way I look and forbid photos. I avoid looking in the mirror and feel uncomfortable when people look at me.

WIBU to speak to my GP after coronavirus has died down with a view to requesting surgery? I'm a single parent and could never afford rhinoplasty privately but I'm also reluctant to ask because I know there are people needing much more important procedures.

I'm not expecting a miracle nose job, I just want it straight again.

I'm not sure they'd even consider it to be honest, but it's worth a try I'd think!

The worst they can say is no

You are not being unreasonable at all, and I think if it’s impeding your breathing they will do it on the NHS. Go for it!

It does affect my breathing in that I can't breath sufficiently through my nose. That feeling you have when you have a heavy cold, I have it constantly.

@PLBV

It does affect my breathing in that I can't breath sufficiently through my nose. That feeling you have when you have a heavy cold, I have it constantly.

Case closed. You should definitely see your GP and explain what you have here.

How does it affect strenuous activity, e.g. running? Do you simply not do it because you can't breathe?

I can't say it'll happen, because I am not someone in charge of NHS prioritisation and the backlog of procedures is going to be very long but it is far from an absurd request.

If you have medical issues like difficultly breathing, deviated septum etc, then yes. But they would be operating to rectify said medical issue rather than making any cosmetic alterations, so your nose will still look the same.

If you just want cosmetic surgery on the NHS, the general answer is no. They sometimes carry out cosmetic surgery on a case by case basic for those presenting with extreme mental distress. It takes various board members to approve such a procedure though, could take years in admin and assessments (both physical and psychological). It’s not an easy route. Your past abuse causing the physical deformity may be an extenuating factor though.

However what I will say is that NHS consultants generally don’t have experience with cosmetic surgery (As they work based on medical need with a disregard to aesthetics) - you might get a better result by going private to a specialist. Remember not every surgeon is the same - they won’t all produce great results; if you get an amateur to operate on you, you might still dislike the end result and want a revision!

I have a family member who has had an NHS nose job. I am not sure what problems he had exactly, but I do know that it was carried out as a solution to rectifying a medical problem rather cosmetic. He was prescribed several other treatments beforehand though, the rhinoplasty was the last resort.

If it's genuinely affecting your breathing and there is no other solution, I don't see why they wouldn't. If it's purely cosmetic, not a chance.

Would you mind saying where you broadly live in eg London? There might be ccg guidance online

How does it affect strenuous activity, e.g. running? Do you simply not do it because you can't breathe?

I couldn't actually tell you because I've been told not to do any strenuous activity like running at all. I have a pelvic prolapse which makes strenuous exercise unsafe

It affects my sleeping though, if I happen to close my mouth whilst asleep it wakes me up as I just can't breath sufficiently through my nose alone.

Eg this nhs trust offers rhinoplasty for Objective nasal deformity caused by trauma. (Yours may not)

www.calderdaleccg.nhs.uk/commissioning-guidelines-for-rhinoplasty-andor-septorhinoplasty/

@Mnhealth202020

Would you mind saying where you broadly live in eg London? There might be ccg guidance online

I do live in London coincidentally, South East London.

I was reading some general NHS guidance about reconstruction for broken noses a few years back, and I think the tenor of the document was , yes, if it is obstructing breathing, but nothing that is purely cosmetic if you're a boxer as the nose is just going to get broken again.

Again, OP meets those criteria.
A) Medical need,
B) not purely cosmetic, and
C) not making her living as a prizefighter!

This is lewisham but applies to all SE CCGs. It’s from 2015 though.

I highly recommend you read section 1 from page 5 as it outlines the procedure for IFR (individual funding requests).

Page 7 says:

Septo-rhinoplasty (Reshaping of the Nose)
This procedure is not available on cosmetic grounds. Septo-rhynoplasty will be considered in cases involving severe nasal deformity with chronic and complete obstruction of at least one nostril due to congenital or traumatic causes with a demonstrable functional limitations.

So your past trauma may be an extenuating factor that may allow you to receive funding

Thank you very much! I will go and have a read now

The initial problems you’ll have are:

1. Are your breathing difficulties severe enough?
2. Are you under the care of a mental health team?

My DH had his nose fixed under the NHS. It caused him some breathing difficulties, he snored like a trooper and a lot of mouth breathing at night. Sounds kind of similar to you. It was pretty straight forward to arrange. He went to the GP and was referred straight off. I don't think he even had to wait very long. It was all done as day surgery so no staying over. Definitely talk to your GP and talk about the breathing issues.

Absolutely request it. You may have to wait a while, but it's worth it.

Sorry for all the posts but this is a more recent document

I had my nose fixed under the NHS some years ago.
I had a deviated septum which caused me problems with breathing through my nose (totally blocked on the left side).
The surgeon asked me if I liked the appearance of my nose (besides the obvious crookedness), so I asked if he could trim the length and remove the hump. My nose isn't drastically different (it's still a little crooked), but I'm much happier with it.

@Mnhealth202020

This is lewisham but applies to all SE CCGs. It’s from 2015 though.

I highly recommend you read section 1 from page 5 as it outlines the procedure for IFR (individual funding requests).

Page 7 says:

Septo-rhinoplasty (Reshaping of the Nose)
This procedure is not available on cosmetic grounds. Septo-rhynoplasty will be considered in cases involving severe nasal deformity with chronic and complete obstruction of at least one nostril due to congenital or traumatic causes with a demonstrable functional limitations.

So your past trauma may be an extenuating factor that may allow you to receive funding

Well obviously they will fix the medical issue.

And if they refuse to fix the cosmetic one at the same time, point out that it is indirect discrimination, because if you hadn't received the injury within an abusive relationship, and had been allowed to go to the hospital at the time, they could have addressed it immediately, covering both issues at once.

I don't see how that quote is relevant though, as the "traumatic causes" just means it was physically injured somehow; it doesn't refer to the emotional circumstances of the event.

@rosiejaune

Thought the relevancy was obvious but I’ll dumb it down for you - I added said quote in as it directly (and entirely) refers to the treatment she desires, out of an otherwise long document.

Furthermore isn’t it obvious that an ex causing her broken nose entailed a “physical injury somehow”? Emotional effects are relevant too, the linked document in my post you quoted goes into detail; both exceptional circumstances (that may not be present in other patients with the same issue) and assessment from mental health services can be a prerequisite to secure IFR for some CCGs. Mental distress alone can warrant cosmetic surgery under the NHS, it is assessed on an individual case basis.

Its likely they will, if its causing you a problem breathing through your nose.
My son, a good few years back, got mugged and his nose badly broken, the nhs did a great job on it. Mind you he went straight to a and e when it happened and they arranged the follow up appt.

I had a septoplasty for a deviated septum caused by a broken nose (breathing issues). The way they do the surgery now though is all internal, using lasers, so there was no option to do anything cosmetic/external
My uncle had the same procedure years ago and when it was done 'manually' it was a more involved and longer recovery but he did had the option of having a bump on his nose shaved down as part of that
You could ask, but there's very little scope for cosmetic work on the NHS with how services have been cut back with austerity

Yes, my Ex had this and the NHS did the op after assessing his breathing.

[quote Mnhealth202020]@rosiejaune

Thought the relevancy was obvious but I’ll dumb it down for you - I added said quote in as it directly (and entirely) refers to the treatment she desires, out of an otherwise long document.

Furthermore isn’t it obvious that an ex causing her broken nose entailed a “physical injury somehow”? Emotional effects are relevant too, the linked document in my post you quoted goes into detail; both exceptional circumstances (that may not be present in other patients with the same issue) and assessment from mental health services can be a prerequisite to secure IFR for some CCGs. Mental distress alone can warrant cosmetic surgery under the NHS, it is assessed on an individual case basis.[/quote]
Yes but how many other causes of nasal deformity are there, other than congenital and trauma?! So basically they will fix all crooked noses if they are significantly functionally impaired, but that part is obvious anyway.

So why didn't you post the bit about mental distress instead, that would justify them addressing the cosmetic aspect too?

Yes I had mine fixed, I fell and broke it and they put it back in place but it was crooked and I couldn’t breathe and had headaches constantly. I went to my go asked for a referral to the ENT explained my symptoms. They referred me and I had and appointment where they looked up my nose. I needed septoplasty they asked if I wanted it straight too seeing as they were there already I said yes as it was straight before the fall. I had septorhinoplasty in November. It was fucking sore I will not lie. But I have not had a headache since really and my migraines, which I have had since a child are also gone. It’s still not completely healed it takes about 12 months.