Nose Was Hit, Didn't Break but is Crooked Now With Breathing Difficulty, What Can I Do?

Question

I was headbutted about 2 months ago, it didn't bleed or hurt a lot, there was a bit of swelling which went down rather quick. Now i'm worried my nose has changed shape, and i have difficulty breathing on one side. What do you think?

William Portuese, MD · Answer

According to the pictures, it appears the nose is slightly concaved on the patient’s left side. There seems to be a disjunction between the left upper lateral cartilage and nasal bone, which is probably from being head-butted. The nasal bones also appear to be slightly crooked to the right side and can straightened out with osteotomies. The midthird of the nose will be straightened with a spreader graft on the left side. Any breathing difficulties within the nose are addressed through a septoplasty procedure. This is done under general anesthesia as an outpatient procedure in an ambulatory surgery center. This type of injury is often covered by a patient’s medical insurance and is not considered cosmetic since it is directly related to a break in the nose with a concurrent breathing difficulty.

Michael M. Omidi, MD, FACS · Answer

Difficulty breathing most commonly occurs form one of the followings:1.  Enlarged turbinates -- sausage like structures that humidify the air that can enlarge from allergies.2.  Narrowed Internal or external valves,  structures in your nose can collapse when breathing in reducing air flow.  Correction requires cartilage grafts to help open the nose at the areas of collapse.3.  Deviated Septum4.  Polyps5. Broken nasal bones restricting the airwayAn examination and/or CT scan can help with the diagnosis. In your case it appears that the bones may have been pushed in during the fracture and would need an operation to be corrected. Best of Luck, An in-person exam with a board-certified plastic surgeon is the best way to assess your needs and provide true medical advice. Best of luck. Dr. Michael Omidi

Babak Larian, MD · Answer

I suggest you make an appointment with an ENT (ear, nose throat doctor) to assess why you are having breathing issues and determine solutions. Your story is typical of a nasal injury and can be corrected with surgery or other treatments.

Talmage J. Raine, MD, FACS (retired) · Answer

Your story is typical for a nasal deformity.  The trauma caused injury to your nasal structures which include bone and cartilage.  The crooked nature of your nose probably is due to warping of the septal cartilage which is like compressing a sheet of aluminum.  The sheet of cartilage that is your septum will warp and cause your nose to be crooked and also obstruct or restrict airflow in nasal breathing.

	Consult with a board certified plastic surgeon.

	All the best,

	Talmage J. Raine MD FACS

Nose Was Hit, Didn't Break but is Crooked Now With Breathing Difficulty, What Can I Do?

Answers (4)

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