Broken Nose Surgery: Fixing a Broken Nose

Everything to Know About Broken Nose Surgery

A broken nose is a rupture or a crack in your nasal bone which commonly results from contact sports, fights, falls and car accidents. These accidents commonly lead to injury over the bridge of the nasal bone. They can also negatively impact the appearance and the functionality of the nasal septum and may also affect the nearby cartilages. The nasal septum is a flexible structure that divides your nose into two halves. It provides structural support for the nose and helps to regulate and ensure smooth airflow through the nasal cavities.

A broken nose is identifiable by pain, redness and swelling, changing nose shape or difficulty breathing. And while it’s painful and uncomfortable, it can be corrected by either manual adjustment or broken nose surgery.

Because a nose job is primarily a cosmetic surgery, many people have the misconception that it is only done for aesthetic reasons. While rhinoplasty is commonly performed for patients who have aesthetic concerns with the shape and size of their nose, a large number of patients seek out rhinoplasty for medical reasons, such as after facial trauma. To find out more, read our blog “7 Medical Benefits of Rhinoplasty Surgery”

Rhinoplasty or nose job is a cosmetic surgical procedure that can help correct a broken nose or a deviated septum. It changes the shape of your nose by modifying the appearance of the bone, cartilage and/or skin. It can be done for medical reasons such as to correct a deviated septum with the help of septoplasty or to reposition the broken nasal bones and ensure that they heal in an aesthetic shape.

Signs of a Broken Nose

People with a broken nose present with a history of injury and:

• Pain, swelling and redness
• Nose bleeds
• Persistent discomfort in or around the nose
• A distorted or curved nose (ie. it’s not as straight as it was before)
• A swollen nose and its nearby area
• Blockage of the nasal passages (or difficulty breathing)
• Wounds around the nose and eyes
• Crunching or crackling sound when you touch your nose

 You should seek immediate medical treatment if you have any of the following symptoms:

• Your nose is bleeding profoundly and constantly
• Clear fluid is oozing from your nose
• You are having trouble breathing
• Your nose looks twisted or distorted

Self-Care Treatment For a Mildly Broken Nose

If the fracture to the nose is not severe or creating other difficulties, treatment to reduce pain and swelling can be done at home. You should avoid any efforts at repositioning your distorted or crooked nose.

Here are a few self-care tips before visiting your doctor:

• Bleeding from the nose can be treated by sitting up and inclining forward, preventing the blood from oozing inside the throat.
• An ice pack should be applied to the nose and its surrounding area for 15-20 minutes per session multiple times a day.
• Take pain-relieving medications, to alleviate pain and swelling.
• Clean and cover smaller wounds with dressings.
• To subdue swelling the head should be kept at an elevated position while lying down.
• Don’t pick or blow the nose.

If the break has displaced your nasal bones and cartilage, your doctor may be able to manually realign them. This needs to be done within 7  days from when the fracture occurred, and preferably sooner.

This is often best done under general anaesthesia. During this procedure, Dr Doyle will:

• Administer medication to ease discomfort
• Open your nostrils with a nasal speculum
• Use instruments to help realign your broken bones and cartilage

A splint will be placed over your nose and a dressing will be placed over your nostrils. If severe, an internal splint may also be necessary for a short time. You will be given a prescription for antibiotics to prevent infection from the bacteria that normally resides in your nose.

Treating a Severely Broken Nose

If your break is severe, you’ve had multiple breaks or you’ve left your break untreated for longer than 14 days, you may not qualify for a manual realignment. This typically requires broken nose surgery to realign the nasal bones and reshape the nose.

If the break has damaged your nasal septum, causing obstruction or difficulty breathing, septoplasty surgery may be recommended. This type of reconstructive surgery is best performed by a Specialist Plastic Surgeon.

How to Fix a Broken Nose

Benefits of Undergoing Broken Nose Surgery

Rhinoplasty after an injury or trauma could be considered for the following reasons:

• Improve the overall aesthetics of the nose
• Improve the breathing function of the nose
• Reduce the likelihood of breathing difficulties, recurring sinus infections and trouble sleeping
• Eliminate any problems associated with a deviated septum
• Protect the nose from collapse

It can also be done if you have cosmetic goals you’d like to achieve. In this case, the cosmetic benefits of broken nose surgery might include:

• Increase or decrease the size of the nose
• Straighten the nasal bridge
• Reduce the size of the nasal bridge
• Reshape the nostrils with combined alarplasty surgery
• Reduce the nasal tip with combined tip rhinoplasty surgery
• Improve your overall facial aesthetic

Determining the Right Treatment – Diagnosis

Just like with any broken bone, a broken nose is not something you want to leave alone to heal itself without appropriate medical guidance. A consultation with a Specialist Plastic Surgeon will assist in evaluating the extent of damage and formulating an appropriate treatment plan. Diagnosis is usually done by carrying out a visual inspection and a physical examination of the person’s face. Dr Doyle will:

• Inquire about how the injury occurred and its symptoms
• Examine for indications of swelling, wound, and bleeding
• Inspect the nose and neighbouring areas
• Examine the interior of the nasal passage

Additional tests like an X-ray or CT scan may be required to investigate for any further potential injuries or complications which might have occurred.

Your Broken Nose Correction by Rhinoplasty Journey

Consultation

An initial consultation is the first phase of your nose correction journey. You will have an in-depth discussion with Dr Doyle about the procedure and if you meet the criteria to undergo the procedure.

Imaging studies like X-ray and CT scan can confirm suspected fractures, which will further complement visual and physical examination findings. Before undergoing the surgery, Dr Doyle will take a detailed medical history from you and discuss your expectations from the surgery.

It helps if you are completely honest about your expectations for the surgery. This can help you achieve your desired outcome.

You are expected to avoid smoking a few weeks before the surgery, along with aspirin and other anti-inflammatory drugs, which may increase the chances of bleeding. You may also be asked to undertake a special wound healing diet to prepare your body and skin for repair.

The Broken Nose Surgery Procedure

Either intravenous sedation or general anaesthesia is used during rhinoplasty and Dr Doyle will recommend the best choice for you depending on the complexity of the surgery.

Rhinoplasty can be performed using a closed procedure or an open procedure. In the closed procedure incisions are hidden inside the nose whereas, in an open procedure, an incision is made across the columella which is the narrow strip of tissue that separates the nostrils. The skin covering the nasal bones and cartilages is then gently raised through these incisions allowing access to reshape the structures of the nose.

Rhinoplasty can be used to change the shape of your nasal bones or cartilage in several ways depending on the severity of the broken nose, how much cartilage needs to be removed or added, the structure of the nose, and available materials. If a small amount of cartilage needs to be added to reshape the broken nose, it can be taken from inside your nose or your ear.

For bigger changes and reconstructive cases, cartilage from your rib or bone from other parts of your body can be used. If the wall between the two sides of the nose i.e. the septum is bent or deviated, it can also be corrected by using cartilage struts inside the nose to improve breathing.

After the required changes are made, the nasal skin and tissue will be placed back and stitches will be applied on the incisions in your nose and in the columella.

Broken nose correction through rhinoplasty usually takes between 2 and 3 hours but it can take longer if the surgery is more complex.

Recovery

Recovery can take anywhere from a week to two depending on the complexity of the treatment. The nasal contour will take time to refine fully. Initial swelling can last for up to a week but will settle over the next 12 months.

You will require someone to drive you home from the hospital where your surgery will be performed and might need to take leave from work for a week or more. It is suggested to avoid the following activities for 6 weeks post-surgery:

• Strenuous physical activities and running
• Swimming

Take care with these activities for the first 2 weeks following surgery

• Blowing your nose
• Excessive chewing
• Any facial expressions that require lots of movement
• Pulling clothing over your head
• Resting eyeglasses on your nose
• Vigorous tooth brushing

A splint will be placed on your nose that will help your nose retain its new shape while it heals. Nasal packs or splints may also be placed inside your nostrils to stabilise your septum. Splints and dressings will be kept for up to a week after surgery.

In case of a minor correction surgery, you will be monitored for at least a few hours after surgery and you will be allowed to leave later that day. However, if the broken nose surgery is a complicated one, you might have to stay in the hospital overnight.

Post-surgery you should keep your head elevated above your chest to reduce chances of bleeding and swelling. You will feel congested if your nose is swollen or you have nasal packing in place. Dr Doyle very rarely uses nasal packs. Absorbable stitches are used in the columella. They will dissolve and do not require removal.

Risks and Complications

Every procedure poses a certain amount of risks, and you must understand these risks and possible complications associated with them before deciding if the surgery is right for you.

In the consultation phase, you will be thoroughly briefed about the possible risks and complications.  These include::

• Bleeding
• Infection
• Anaesthetic risks

Apart from these general risks, other possible risks specific to rhinoplasty include but are not limited just to:

• Difficulty breathing through your nose
• Permanent numbness in and around your nose
• The possibility of an uneven-looking nose
• Pain, discolouration, or swelling that may persist
• Scarring
• Septal perforation
• A need for further surgery

Broken Nose Surgery Frequently Asked Questions

What does a fractured nose look like?

A fractured nose shows the following signs:

•  Distorted or curved nose
•  Swelling on the nose and its surrounding area
•  Bleeding from your nose
•  Bruising around your nose and eyes

How long does it take to recover from broken nose surgery?

Initial swelling post-surgery will gradually subside over a week but expect it will take up to 12 months to see a final result.  Stitches will dissolve in the first week, while recovery can take up to four weeks.

Is nasal bone fracture a medical emergency?

If you show any of the following symptoms after a nasal bone fracture it should be considered as an emergency:

• Your nose is bleeding heavily and constantly
• Clear fluid is draining from your nose
• You are having difficulty breathing

Can a broken nose be fixed without surgery?

Yes, a broken nose can be fixed without surgery only if the bones and cartilage in your nose have been displaced. It may be possible to manually realign them with a non-surgical procedure called closed reduction. To obtain the best results from a closed reduction it should be performed within 7  days of the fracture.

Do you X-ray a broken nose?

Diagnosis of a broken nose can be done through a visual inspection and a physical examination of the person’s face and an X-ray is usually not required. An X-ray may be requested to investigate for other injuries or complications.

Does insurance cover a broken nose surgery?

Purely cosmetic surgery is never eligible for a rebate from Medicare or your private health insurance funds. Funds such as BUPA, AIH, Allianz, Australian Unity, HCF, Medibank and others do cover some medically indicated Plastic Surgery procedures such as Septoplasty, Septo/Rhinoplasty and surgery for breathing difficulties. If you have a post-traumatic deformity (caused by your broken nose) or if breathing is a significant problem, may qualify for a Medicare item number. You can read more about this in our blog Will Medicare Cover My Rhinoplasty in Queensland?

Can a broken nose be fixed after two weeks?

It won’t be possible to manually realign your broken nose after two weeks, but surgical procedures like rhinoplasty can be performed to reshape your broken nose.

What type of doctor fixes a broken nose?

An ENT (Ear Nose and Throat) surgeon or plastic surgeon can fix a broken nose. If your issues are of a cosmetic nature this surgery is commonly done by a Specialist Plastic Surgeon. ENT surgeons are commonly involved if breathing difficulties are the main issue.

Is a broken nose correction surgery worth it?

Broken nose surgery could be worth it for you if you are not happy with the appearance of your nose following the break or if you continue to experience breathing difficulties after it heals.

Can you straighten a broken nose?

A broken nose can be straightened through both non-surgical and surgical ways. Manual realignment of the broken nose can be performed through a non-surgical technique known as closed reduction. This is best done within 7 days of the injury. Rhinoplasty is a surgical method that can be used to straighten a broken nose.

Will my broken nose go back to normal?

If the fracture to the nose is not serious or causing any other problems, by using some self-care tips and if the swelling subsides after 3 days, your nose may return to normal after 3 weeks. However, in severe cases, either manual realignment or surgical procedures must be performed to correct your broken nose to its new normal.

Book a Consultation

If you are suffering from a broken nose and believe you would benefit from broken nose surgery, book a consultation with Specialist Plastic Surgeon, Dr Mark Doyle.

References: 

• A Broken Nose – Broken Nose Surgery – ENT Clinic Sydney 
• Recognizing a broken nose: Self-care, treatment, and recovery 
• Broken nose – NHS 
• Rhinoplasty | American Society of Plastic Surgeons 

Related Blogs

• Common Nose Shape Concerns That Nose Surgery Can Help – Benefits of Rhinoplasty
• Will Medicare Cover My Rhinoplasty in Queensland?
• Combining Plastic Surgeries: When Can Multiple Procedures Be Combined?