You are still early in the post op period and some of the problem may be swelling. This will take months to totally resolve. It is not uncommon for apatient to need a formal rhinoplasty after a nasal fracture to obtain the best result. Only so much improvement can be obtained by the closed reduction alone. After 6 months you can decide if you would like to proceed with a rhinoplasty or nothing if you are happy with the closed reduction result. Good luck. Donald R. Nunn MD Atlanta Plastic Surgeon.
Appears in the posted photos the superior fracture deviation gone or created. But the bulbous tip is the same. You needed a rhinoplasty plus nasal fracture reduction...
Nasal fractures can present a significant challenge for treating surgeons. The nasal anatomy is very complex and involves not only bone but cartilage. Diagnosing the exact underlying problem and the areas affected by the traumatic injury are necessary to correct the problem. Treatment can be as simple as a close reduction, which means that the surgeon simply moves the bone back into the original position, to complex surgical repair that involves the bone, nasal and septal cartilage. Often, if the closed reduction fails to correct the problem, then a more complex surgical reconstruction is necessary.
Early intervention in the cases of acute nasal trauma is often the best way to avoid the need for significant corrections in the future. Unlike planned, elective rhinoplasty, the degree of correction that can be achieved is often dictated by the nature of the injury or fracture pattern. The goal in a closed reduction is to reduce the fracture as best as possible and then follow along to see if future correction is warranted. In your case, it seems your surgeon has reduced the fracture to some degree. I would recommend continued observation for now.
Just one week following a closed production, you are still going to have a significant amount of swelling. It does appear that the nasal bones have been repositioned to some degree, however it is difficult to tell to what extent. Give yourself more time for the swelling to subside, and if the nose is still crooked you can always undergo an open procedure to fix the problem.
It is always difficult to assess the final result so early in the healing process.
Kenneth Hughes, MD
Los Angeles, CA