Is it absolutely necessary to have Rhinoplasty for nose realignment within 10 days of the injury? Would 18 days be way too late? I fear my husband's appointment to have this done is too late and that he may need extensive surgery.
Nose Realignment Should Be Within 10 Days of Injury?
Doctor Answers (5)
Within three weeks after injury
After a nasal fracture, it is usually important to have the nose reset within the first three weeks after the injury. It is important to reset the nasal bones back to their original preoperative state, which is straight, rather than waiting for them to heal crooked.
Nose realignment not absolutely necessary, but better
In general, the sooner it can be realigned, the better. If it is not taken care of early, the broken bones will start healing in the wrong position. It is much harder to move them back to the correct position after about 10 days.
If the nose can't be realigned within that window, then it is usually best to allow complete healing and resolution of swelling before attempting to fix it again. It might be a little more complicated. However, it rarely means that an "extensive" surgery will be needed.
I prefer to let the swelling go down for a few weeks and then I can rebreak the bones if necessary. I think I pick up small changes that I would have not seen in the first 7 days. Having said that, if someone wants to have the bones just pushed back, that is done 7-14 days after.
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Surgery after Nasal Fracture
The reason to see a nasal surgeon soon after nasal trauma is to exclude a blood collection under the lining of the septum (septal hematoma). In addition, a closed reduction can be successful in the appropriate situation but should be done within the first 7 days or so. I would not attempt a closed reduction18 days after the injury but rather wait longer. If there are not really severe breathing issues present, it may be best to wait a total of 9 to 12 months for the the final rhinoplasty procedure.
Acute Injuries Should be seen within 7 days
It is best to see patients who have experienced nasal trauma within seven days of the injury. A septal hematoma must be ruled out to prevent permanent cartilage damage. Additionally if the nose is crooked then it is best to attempt to straighten the nose within 10 days of the injury to avoid even more trauma to the nose. If the nose is straight and a hump has developed on the bridge then acute intervention is not indicated and observation over the next 2 months is indicated. Then if there are objectionable changes then Rhinoplasty must be done.