Rhinoplasty: Q&A
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How Long Before I Can Surgically Repair an "Acute Nasal Fracture"
Hi I live in San Fran and had to go to the ER yesterday after I was hit in the nose; I got X-rays and diagnosed with an "acute nasal fracture". I was advised to go see a nose doctor in 5 days to remove the stitches and talk about the possibility of getting a surgical repair since my nose has shifted. How soon can I have the nose repaired? Would insurance cover the rhinoplasty portion as well? If not what would be the out of pocket cost for that portion (my ins coverage has always been good)?
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13 Doctor Answers |
Asked by
jebox
in San Francisco, CA
+2
A broken nose should be reset as soon as possible.
A fractured nose with displaced bones should be reset as soon as possible (days). Because of the excellent blood supply in the face, the bones can reset in an unwanted position very quickly. Fixing the problem might then require refracturing which is more involved than simply reducing and setting a displaced fracture.
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Nasal fractures should be reduced within two weeks of injury
Nasal fractures should be reduced within two weeks of injury. This typically involves a "closed reduction" where the nose is numbed (you might also be given some "twilight anesthesia") and the nasal bones are replaced to their position prior to your injury. With regard to your question about insurance coverage, closed reduction is often covered. I have experienced some situations where insurance would not cover closed reduction after 14 days following the injury (makes no sense, indeed)....
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+2
Acute Nasal Fracture
An acute nasal fracture should be repaired (reduced - the bones lined up) within 10 to 14 days after the injury. If it is not done immediately at the time of injury, it is best to wait 48 to 72 hours for the swelling to subside so the nasal contour is easier to visualize. Any rhinoplasty procedure that involves "cutting and breaking bones" should not be performed for at least six months after the initial closed reduction.
Insurance should cover the...
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Nasal fracture treatment in the first weeks after injury
Sorry to hear about your injury.
You should call your primary care doctor to get an urgent referral to a facial plastic surgeon or plastic surgeon. If you can self - refer, then call to make an appointment.
As the swelling goes down, your surgeon and you can make a decision about a "closed reduction"
If you have sutures, then it may be best to have them removed on the 5th - 7th day after injury.
Best Wishes
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When nasal fracture can be surgically repaired
An acute nasal fracture is best repaired after the swelling has subsided. The ideal time is between day 10 and 21 after the injury when it has been long enough for the swelling to resolve and allow your surgeon to accurately identify the crookedness of the nasal bones, but early enough that the bones have not healed crooked. This makes it easier to reposition the nasal bones back to the normal anatomical position.
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Acute displaced nasal fractures
Acute displaced nasal fractures should be reduced within two weeks. My ideal time is ten days except a little sooner in a child and a little longer if there is massive swelling and bruise or lacerations. At that point the swelling is usually down so the reduction can be done with visual cues and by feel, and the bones usually stay in place nicely without packing or splinting. I generally do this in the office for patients who are comfortable with the...
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Fort Myers Facial Plastic Surgeon
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Broken nose
Go see your doctor as soon as possible. There is a window where a closed reduction of nasal fracture can be performed. Generally, we wait 3 to 4 days after injury to allow the swelling to subside. We then have up to two weeks to have a closed reduction. This procedure manipulates the bones back to the pre-injury form, without making any incisions or being involved. If you wait longer than this golden period, manipulation becomes impossible since the nasal bones have already settled...
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Surgical Repair of Acute Nasal Fracture
If x-rays showed a fracture it is located within the nasal bones. When the repair involves only repositioning of the bones without incisions it is best done within 2 weeks, before the bones start to fix. An open reduction and rhinoplasty can be done anytime after the gross swelling has resolved. Insurance companies will frequently pay for the rhinoplasty after a nasal fracture. Your surgeon will help you determine the insurance benefits.
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Treating acute nasal fracture
An acute fracture is usually reset within the first 7-14 days. I would get in to see a nose specialist to get things checked out as soon as you're able to get in.
Insurance normally covers the fracture reduction procedure. Your surgeon's office should be able to give you a better sense of what would be covered.
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Nasal fracture
The nasal fracture should be repaired if the nose has shifted within the first 3 weeks after the injury -- preferably between the 7th and 14th days post injury when most of the edema has gone down. If there is no cosmetic change, then nothing needs to be done. It's your insurance, call them to see if it will cover.
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Nasal fracture
Acute fracture should be reduced in a closed fashion within a week or two. Remember that refinement of bumps ,etc. can then be done when everything settles down within 6 months or so. Trying to do fine adjustements now may cause a collapse. On the contrary, waiting to reduce the fracture will make it more difficult to recentralize it.
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Septorhinoplasty and I surname coverage
Depending on your insurance company and the cause of your fracture most companies pay for nasal fracture repair. You should see a surgeon soon and depending on the swelling caused from the fracture and/or other trauma the surgeon will decide when a surgical procedure is to be done. Most of the time you can preauthorize your insurance and send them your medical records from ER etc and they will determine amount of payment depending on the surgeon, facility and out of network expenses unless...
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Post-Traumatic Rhinoplasty
After an acute trauma such as the one you describe, you will have nasal swelling, which makes it hard to fix. This is why you are advised to see someone several days later. If there is nasal airway obstruction following the trauma, you may likely have insurance cover any functional aspects of reconstruction. Bear in mind, that the insurance company may ask for a pre-certification or pre-authorization before any surgery takes place, which can sometimes take quite some time....
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