In injury, when and how is nasal cartilage reset on bone after rhinoplasty if bones do not break?

Question

I had a good rhinoplasty but was hit in the face. The nose hurt, shape changed & stretched, & the entire nasal tip pivoted to the left. My nasal bones have never broken,but upper lateral cartilage definitely pulled off the bone,leaving painful spots. I followed up with my surgeon at 6 weeks, 3 months, 6 months, & 1 year after surgery. How could a surgeon reset nasal cartilage so it would have healed properly? In that time, the shape change was never addressed, & eventually the nose collapsed.

John Layke, DO, FACS · Answer

Unfortunately, this is a difficult situation, as your surgeon did the right thing by not operating immediately.  Depending on the actual damage to the cartilage, we can sometimes place splints internally and externally to help shape the nose.  In many cases, we just have to wait for the nose to fully heal, and repair it at 9-12 months.

Jeffrey Marvel, MD · Answer

Trauma to the cartilage is more difficult to manage than bone.  Bone can usually be reset or "popped" out into position.  Your siutuation sounds as if the cartilage tore loose from the nasal bones, causing them to collapse.  The repair usually requires suturing and spreader grafts.  Your doctor did the correct thing by waiting.  Nothing can be done in the short term other than a wait and see approach.  The spreader grafts are usually harvested from the septum.  The operation has about a 5-7 day recovery.  Good luck in your recovery.

In injury, when and how is nasal cartilage reset on bone after rhinoplasty if bones do not break?

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