Rhinoplasty carries a reputation as one of the more expensive procedures Dr. Frank Agullo performs, and pricing is nearly always one of the first questions in a consultation. He doesn’t dodge it. The starting price is $15,000, and revision starts at $18,000. Here’s what that number includes, and why it moves.
What the Price Includes
“The published price on our fees page includes everything you need to undergo a rhinoplasty,” Dr. Agullo says. “This is the surgeon’s fee, the anesthesia fee, and the operating room fee.” It also includes preoperative and postoperative vitamins, supplements like Arnica and Bromelain for bruising and swelling, ice packs, and every follow-up appointment. The only cost outside that price is picking up prescription medications at the pharmacy.
Why Prices Vary So Much Between Surgeons
Several factors move rhinoplasty pricing from surgeon to surgeon. Location affects overhead and anesthesia and OR fees, which run higher in some cities than others. Board-certified surgeons often charge more than non-board-certified physicians, reflecting additional training and experience. Demand for a surgeon’s rhinoplasty work, the consistency of before-and-after results, and patient satisfaction all factor in.
“When you see an offer that’s too good to be true, it usually is,” Dr. Agullo says. Surgeons offering unusually low prices often cut surgical time or rush the procedure to reduce anesthesia and OR costs, or they’re less experienced and pricing lower to build a rhinoplasty practice.
What Actually Changes the Cost
| Factor | Price impact |
|---|---|
| Primary rhinoplasty, standard | Starting at $15,000 |
| Open technique with significant tip work | Longer procedure, more controlled and lasting contours |
| Weir incision (ala width reduction) | Adds time, increases cost somewhat |
| Revision rhinoplasty | Starting at $18,000, often requires grafts from elsewhere on the body or a donor source |
| Rhinoplasty plus chin implant | Starting at $18,000 |
Most primary rhinoplasties are standard cases running two to two and a half hours. Significant tip work usually calls for an open technique, which takes longer but delivers more controlled, longer-lasting results. Revision rhinoplasty raises the cost the most, since grafting material often has to come from elsewhere in the body or a donor source, and these cases run considerably longer.
Insurance and Deviated Septum
The practice takes a holistic approach to rhinoplasty. “I don’t take insurance myself, but I still take care of the problem,” Dr. Agullo says. A deviated septum diagnosed before or during surgery gets addressed at the same time as the cosmetic rhinoplasty. If a patient wants a septoplasty or turbinate resection billed through insurance, that requires the procedure to happen at a Medicare-certified surgery center or hospital, and the patient still pays out of pocket for the cosmetic portion’s OR time and anesthesia there, typically at a higher rate than performing the full case at the practice’s own accredited cosmetic surgery center.
Why Getting It Right the First Time Matters
“A rhinoplasty is a very technically demanding procedure,” Dr. Agullo says, “and it requires vast experience and great communication with the patient to understand what they’re truly looking for.” The practice uses 3D imaging to help patients visualize technically feasible outcomes before surgery. Rhinoplasty results also can’t be hidden, since the nose sits in the middle of the face, which is part of why Dr. Agullo emphasizes getting it right the first time. Revisions, in his experience, never quite match a well-executed primary result, and they cost more, not less.
What to Ask Beyond the Price
The practice recommends looking at a surgeon’s reviews and the volume of them, consistency across before-and-after photos, and whether the facility is accredited. Confirm real follow-up access, ideally around the clock after surgery, board certification, and good rapport during the consultation, since rhinoplasty results take about a year to fully settle.
Financing
Southwest Plastic Surgery works with PatientFi, AlphaEon, Cherry, and CareCredit, and also offers a direct payment plan through the practice, letting patients pay toward surgery ahead of time on their own schedule. Credit cards, cash, and outside financing are accepted as well.
Filler as a Non-Surgical Alternative
Liquid filler rhinoplasty costs significantly less, typically around fifteen hundred dollars, with no anesthesia or operating room required. It’s temporary, and it works by adding volume, which makes the nose larger rather than smaller, camouflaging a small hump rather than removing it. “Filler doesn’t really go away, it migrates,” Dr. Agullo says, noting that some patients see the bridge or tip widen over time as it dissipates. Patients considering surgical rhinoplasty later typically need the filler dissolved first with Hylenex.
Hidden Costs and Revision Policy
The goal of a primary rhinoplasty is a correct result the first time. Some outcomes depend on factors outside a surgeon’s control, like individual scarring, swelling resolution, and cartilage memory. The practice waits at least a year before considering any revision, to allow full healing. When Dr. Agullo agrees a revision would improve the result, he waives his own surgeon’s fee, and the patient is only responsible for the OR and anesthesia.
The Practice’s Approach
Dr. Agullo, who completed his plastic surgery fellowship at Mayo Clinic and serves as Clinical Associate Professor of Plastic Surgery at Texas Tech University Health Sciences Center, has been named a Castle Connolly Top Doctor for thirteen consecutive years.
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Cross-links
- Editorial version on drworldwide.com: “The Rhinoplasty Price Nobody Explains: What $15,000 Actually Buys You” (link once live)
- Patient-facing version on agulloplasticsurgery.com: “What Rhinoplasty Actually Costs in El Paso” (link once live)
