“Did you have a nice nose before?” the doctor asked. Wait, I thought. Before? She’s saying my nose is no longer nice. “I guess it was nice, it definitely wasn’t bad,” I responded. “Well, this is one of the worst breaks I’ve seen… how much do you care about how you look?” she asked.
I sat in the center of an exam room in an upright pleather chair, fluorescent light above me, crinkly hygienic paper below me. Three women awaited my answer. My girlfriend on the left, the nose surgeon in the center, a nurse on the right. How much do I care about my looks? I had never thought about that directly. I had gotten used to people saying that I was a good-looking guy, but that hadn’t contributed to any sort of ego. Or had it?
In a split second, my looks had been taken from me. My buddy, carrying a giant log of firewood over his shoulder, turned around hastily and accidentally bashed me across the face. I went down hard. When I got to a mirror, I couldn’t believe it. My formerly straight nose was now shaped like a C, and it was resting on the left side of my face. Puffy black eyes were forming. Was that really me in the mirror? I better not look like that forever.
Back in the doctor’s office, thoughts whizzed by as I tried to answer her question about my looks. The nose is the focal point of the face. Will people be distracted when they talk to me? What about the fact that good-looking people make 4% more annually? If I admit that I care about my looks, does that make me vain? I’m not vain! Shit, am I vain?
“I guess I do care about how I look,” I responded to the three women in the exam room. “OK, here are your three surgery options,” the doctor said.
The doctor presented my surgery options from least to most complex, like the carwash guy presenting the basic wash up to the works. Option one, set my nose without anesthesia – cheapest option, somewhat effective. Option two, set my nose under anesthesia – medium cost, usually effective. Option three, get a rhinoplasty (aka nose job) – very expensive and very effective – a sculpted work of art.
I had a strong aversion to the rhinoplasty – it required 6 months of recovery with no water exposure (good luck keeping me out of the water for 6 hours). It seemed like it would drown me financially, AND what if I ended up with a Michael Jackson nose?
But the thought of a rhinoplasty made me curious: who elects cosmetic surgery knowing the chance of failure and recovery time? Answer: a lot of people – over 11 million Americans chose cosmetic procedures in 2013, totaling $12 billion in expenses. Wow! 90% of them were women, whose #1 procedure was breast augmentation. If you combine women and men, nose jobs are the fifth most popular procedure. While I was trying to get back my looks that were taken from me, far more healthy people were lining up to alter their given looks.
With a nose job off the table (for now), I chose to do an “asleep” reset of my nose (procedure with the highest chance of success, given that I cared about cost). But seriously… how much was this going to cost me?
I thought about my current health insurance plan – a low premium, high-deductible plan. I had decided to pay less on my monthly premiums, betting on my healthy lifestyle. Surely, an active guy who does lots of risky new activities won’t get hurt, right? I felt an expensive rumble of regret in my gut.
I ran around frantically for the 3 days pre-surgery to get answers. How much was the surgery? Was it in-network or out-of-network? How would that affect my deductible and out-of-pocket expenses? Could I negotiate the price? No one knew a thing, or at least they weren’t telling me. My insurance company came up with nothing, the doctor’s office nothing, and the hospital quoted me a price somewhere between $4,000 and $15,000. Super precise, thanks.
I was kicking myself for not changing my health insurance when I moved to Hawaii, and for not enrolling through Stride. Stride’s member experience team could’ve been working as my consumer advocate, but instead I was alone in this mess. [Disclosure: I contracted for Stride for a year and a half. The hassle of this incident is definitely a reason I decided to join the team, to help change and humanize the health care system].
By the time I rolled into the operating room, I had near-zero information and was resigned to pay my full deductible ($6,500). This better work I thought. The Beatles “Ruby Tuesday” was playing, and the anesthesiologist told me the drugs would hit me in 5 minutes. But he tricked me – I remember making one stupid comment to the doctor then BAM… I woke up in the recovery room.
I had to wear a hideous nose cast for 10 days after my surgery. My girlfriend and I dubbed it “the beak,” and it made kissing very hard (who realized how important nose contact is?). From time-to-time, we talked about my new nose under the cast. Was the surgery a success? Or would I need a nose job to fix things? Under the cast lurked a great surprise.
When the doctor finally pried off the cast, I was nervous. I took a look in the mirror… and I had to admit, I didn’t hate what I saw. It definitely wasn’t my old schnoz, but it was pretty darn close. I’d tell people, “It’s about 90% my old nose… I actually kinda like its new left curve.” It didn’t need to be perfect, and so I suppose that means I’m only medium vain.
Epilogue: This incident happened in April of 2015. The surgery was almost exactly my deductible of $6,500, meaning my insurance company paid almost nothing. A medium-sized medical expense like this is a Bronze Plan buyer’s worst nightmare. I’m leaning against buying another high-deductible plan for 2016. Good luck out there. Watch out for friends carrying logs over their backs. They’re not trying to change your face, but they just might.
[This post was written for Stride Health but all opinions are my own]