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Do I Need Surgery After Closed Nose Reduction from Fracture? (photo)

recent ski accident fractured my r. nasal bridge by eye & caused depr. of nose on the right side.left nasal bone cracked. ent perf. closed nose and the l. side looks great - bones popped together. nose is straight for the most part but the right side is still depressed slightly (i notice it). the bridge still is broken when i run my hand along it. septum deviated more, at 80+% deviated to the left. do i need surgery to fix this? should i rasp my nasal hump? not looking for any major nose change

Doctor Answers (2)

Rhinoplasty after post-traumatic nasal fracture reduction

+2

Hello 'geeter80210', thanks for your question.  You did not mention the extent of comminution or deviation of your nasal fracture and how long ago it was surgically reduced.  Also, without pre-injury photos, it is difficult to determine and compare your 'baseline' photos from your post-traumatic photos.  Many people are born with asymmetric nasal bones, dorsal nasal hump, or a deviated septum without having had any traumatic episodes, which people only notice and realize they had after a traumatic incident in which they hyper-analyze their faces.  Regardless, if your injury and reduction were within the past 2 weeks, if you are convinced that there is definite bony depression on one side, you are still within the window where the bones are still malleable and can be further reduced into position without a major procedure.  However, be warned that post-traumatic swelling is very common in the nose and may give the false impression that the nasal bone is still deviated, when all it is is soft tissue swelling.  A CT scan of the face will give you definitive information regarding the positioning of your nasal bones and septum if you are unsure.  If it has been over 2 weeks, my advice is to give it time and let things settle down and swelling to go away to reassess your nose.  If you still have significant deformity after at least 6 months, then you may be a candidate for a reconstructive rhinoplasty, which is a bigger surgery involving re-breaking your nasal bones to set them in place.  Just as a warning, most insurance companies may not cover this unless there is documented airway breathing problems since they do not care about cosmetics, and only focus on functional issues.  They definitely will not cover dorsal hump reduction or other aesthetic improvements to your nose.  However, if you are willing to pay out of pocket for a cosmetic rhinoplasty, that can address all of your concerns.  Be sure to go to a board-certified plastic surgeon who can go through these options in more detail with you.  Good luck!

-Dr.92660


Newport Beach Plastic Surgeon
5.0 out of 5 stars 1 review

Surgery following trauma to the nose

+1

Hello, and sorry to hear about your accident. How long ago was your closed nasal reduction? In general, surgery would be necessary to fix the issues you describe. Correcting a deviated septum will not result in a cosmetic change. If you wish to have any cosmetic work such as rasping a nasal hump, this can be performed subtly. A good surgeon will be able to make minor changes that complement your other facial  features. From here, I would recommend a consult with a board certified rhinoplasty specialist. They may use computer imaging software to morph a photo of you and give you an idea of how the final result of surgery may appear. I hope this helps, and I wish you the best of luck.

Paul S. Nassif, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 32 reviews

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