Waiting Before Having Broken Nose Fixed?

Question

I broke my nose almost 3 weeks ago while out of town. I have been told by the ENT that I will now have to wait 3-6 months for surgery to straighten it with a plastic surgeon. Is this true?

Richard J. Bruneteau, MD · Answer

Nasal fractures occur frequently following facial trauma.  When patients have obvious or displaced nasal fractures, they will usually require corrective surgery.  Not all nasal fractures require treatment.  In some cases, the bones and cartilage aren’t displaced and because of this, surgery isn’t indicated.
            When corrective surgery is performed within three weeks of the fracture, closed nasal reduction is performed.  This is a relatively simple procedure that re-positions and stabilizes the nasal bones.  If repair isn’t done within three weeks of injury, bone healing has usually progressed to the point where formal rhinoplasty is necessary to correct the problem.  This should be delayed for at least six months to allow stabilization of the boney nasal structures.

David C. Pearson, MD · Answer

Waiting three to six months seems like bad advice. While I usually recommend against "immediate" reduction of a fracture, I usually like to treat patients after 5-7 days, but before 2 weeks. By two weeks, the bones are often beginning to heal in place and will require more effort and sometimes osteotomies (bone cuts) to get the nose adequately straight.
More significant problems can occur with delays beyond 4-6 weeks, since the bones themselves start to "remodel" and can take on permanent shape changes that require more extensive rhinoplastic correction.
All the best,
--DCP

Richard W. Westreich, MD · Answer

I would try to get a closed nasal reduction within the week. It can often still be done as far as 1 month after an injury if the bone has been shifted significantly.
I would then wait the 3-6 months proposed to see if additional corrective procedures are needed. Usually, they are not.
Good luck

Tanveer Janjua, MD · Answer

After a broken nose that needs surgery to straighten it, you can have it done as soon as you want. The reason we like to wait for a few days (3 to 5days) is to let the swelling go down to have a better idea of how bad the nose looks. There is no advantage to wait longer than one week after the injury.
Regards

Michael A. Persky, MD · Answer

Hi Chi,
Best to reset the bones of a nasal fracture within the first 10 days, the latest is about 18 days, at which time the bones have formed callus (they are healing back together).  Early on, the bones can be reset without any incision (closed nasal reduction).
 Many of us then recommend about 4 to 6 months to allow all of the healing forces to settle before rebreaking the bones and straightening the nose.  If done sooner, studies have shown that  there may be a higher revision rate because of those scar tissue healing forces.
At least you will be able to make up some creative stories about your nasal fracture in a city like Chicago (Blackhawks, Bears, City Organizers).
Good luck and be well.
Dr. P

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Waiting Before Having Broken Nose Fixed?

Answers (10)

Answer: Broken Nose Can Be Immediately Fixed

Answer: Broken Nose Can Be Immediately Fixed

Answer: Nose Fracture, When is the Optimal Time to Have it Fixed?

Answer: Nose Fracture, When is the Optimal Time to Have it Fixed?

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Our mission is to create a world where every investment in modern beauty is Worth It.