Waiting Before Having Broken Nose Fixed?

Nasal fractures occur frequently following facial trauma.  When patients have obvious or displaced nasal fractures, they will usually require corrective surgery.  Not all nasal fractures require treatment.  In some cases, the bones and cartilage aren’t displaced and because of this, surgery isn’t indicated.
            When corrective surgery is performed within three weeks of the fracture, closed nasal reduction is performed.  This is a relatively simple procedure that re-positions and stabilizes the nasal bones.  If repair isn’t done within three weeks of injury, bone healing has usually progressed to the point where formal rhinoplasty is necessary to correct the problem.  This should be delayed for at least six months to allow stabilization of the boney nasal structures.

There is no reason to wait six months to have a broken nose corrected. Repair of the nose can be done at any time one week after the injury when the severity of nasal crookedness is visible. The nose is reset through placement of medial and lateral osteotomies. Any fracturing of the upper lateral cartilages off the nasal bones need to be corrected with spreader grafts. Internally, the septum is usually fractured off the vomer and the perpendicular plate of the ethmoid; these issues will also need to be addressed at the time of surgery.

Waiting three to six months seems like bad advice. While I usually recommend against "immediate" reduction of a fracture, I usually like to treat patients after 5-7 days, but before 2 weeks. By two weeks, the bones are often beginning to heal in place and will require more effort and sometimes osteotomies (bone cuts) to get the nose adequately straight.
More significant problems can occur with delays beyond 4-6 weeks, since the bones themselves start to "remodel" and can take on permanent shape changes that require more extensive rhinoplastic correction.
All the best,
--DCP