Broke Nose 3/2/11 - How Soon Can I Have Rhinoplasty?

I agree that unless it is a compound fracture and extremely swollen, you should be safe to have your surgery in 4-6 weeks after your injury.  Ask your plastic surgeon for advice on timing.

It  is best to wait til the swelling goes down and this is 4-6 weeks. Your surgeon should be able to see what is what then.

I read your concern. In most cases of nasal trauma, swelling and bruising is almost gone in a month. I think it's prudent to heal from your nasal trauma before proceeding with your Rhinoplasty Surgery.  It should be ok to proceed with your rhinoplasty by the middle of April if your trauma was 3/2.

All the best with your surgery. I hope this is helpful for you.

Regards from NJ:

Each surgeon has their own particular approach to how they treat broken noses. If the only problem is shifting of the nasal bones to the side, they can be repositioned by what we call a "closed reduction." Unless you are seen right after trauma, the nose is usually too swollen to do this right away. However, after about two weeks, the bones start to heal so the ideal time is somewhere between 3 days and 2 weeks.

If there is a simultaneous deviated septum, cartilage heals differently. I prefer to wait at least 6 to 8 weeks before treating the septum. So, if both are present, I delay fixing the broken nose and re-break it when I fix the septum so the patient only has one operation.

As for a rhinoplasty, I prefer waiting at least two to three months to let everything heal and settle if I we are to do more than straighten the nasal bones and a deviated septum.

Rhinoplasty (nose job) after a broken nose (nasal fracture) is all about timing.  If the bones are displaced and crooked initially, a closed reduction of the fracture may be a good option to reposition the bones in the fist 2-3 weeks after the injury.  If your concerns are strictly functional and the surgery is for breathing, your surgery can be performed as early as 3 months after surgery.  However, if your concerns are cosmetic and you want to make specific changes to the tip of your nose and refinement to the nose overall, it is best to wait about 6 months (depending on the severity of the injury) before pursuing cosmetic rhinoplasty.  Hope that helps!

Dear Columbia - thanks for your question - I think that most would agree that waiting for the majority of fracture healing to be complete (4-6 weeks) prior to a formal rhinoplasty (nose job) is in your best interest.  The healing of the nose is an unpredictable process and this is one reason that the Rhinoplasty is the most difficult operation we as Plastic and Facial Plastic Surgeons perform. Once the injury from the fracture is healed, the rhinoplasty which is in and of itself another injury is much more predictable and able to be manipulated to achieve your best outcome. 

After a broken nose, patients have 2 options.  Option 1 is to do a closed reduction.  This merely puts the bones back to their original  location.  The advantages with this is that it can be done quickly and within 7 days after the accident.  The disadvantage with this is that the technique is not exactly predictable.

I find that a septorhinoplasty is more predictable and gives much more reproducible results.  I would undertake such a procedure about 4 weeks after the original accident to minimize acute swelling after the initial accident.

Raghu Athre

Double Board Certified Facial Plastic Surgeon

Houston, TX

While plastic surgeons will have preferences in timing about a rhinoplasty after a nasal fracture, the most important step is to see what the nose looks like after the swelling from the fracture has subsided. That will take about 6 weeks to have an accurate view of what your nose looks like. If it is just fixing the fracture, then you can go ahead and do it at that point. If the rhinoplasty is going to be more complex and complete, the timing may be longer based on your rate of healing and what internal structures are to be manipulated. In some cases, it may be wise to wait until 6 months or longer. While you anxious to complete this before summer, the results from a rhinoplasty done when the nose is not well healed may make you regret that decision later. Listen to what your plastic surgeon recommends and do not push for early surgery just because the timing is better for your personal schedule. The only mistake you can make with your septorhinoplasty timing is going too early, not too late. 

Your doctor is correct to wait at least 4 months. I personally like to wait about 6 months to insure everything is healed.  If you perform rhinoplasty at this point, you may have problems with loose nasal bones etc..

Surgeons will have preferences concerning the timing of rhinoplasty after a nasal fracture and there is no simple right or wrong answer. After nasal fracture, we like to complete reduction within a week, and feel that rhinoplasty can be performed to reduce the hump, shape the tip, etc, at the same time. If the early window is missed, we like all of the swelling from the fracture to be down. This may take a month for some, perhaps two for others. Four months is long time to wait with a crooked nose from a fracture. You may wish to get another opinion to make sure you have the 'best' rhinoplasty surgeon for you.
Best of luck,
peterejohnsonmd