Do the ULC’s follow the bone in an open reduction of nasal fracture? (Photo)

Question

Hello, I would like to do an open reduction of a nasal fracture because I broke my nose and was wondering if the ULC’s follow the nasal bones when they get reset ? If not, is that when grafts are necessary ? Thank you.

Eric M. Joseph, MD · Answer

Based on your limited photo, you appear to have a reverse C-shaped appearance to your nose. Sometimes the upper lateral cartilage does indeed follow the nasal bone and lead to a straight appearance. Sometimes a cartilage spreader graft is necessary on the concave side, especially when this is after trauma. Please consider meeting with a reputable rhinoplasty specialist if you are considering surgery. Thank you for this question. Sincerely, Dr. Joseph

Gary M. Horndeski, MD · Answer

The ULC's are not attached to the bone.  If you are having an open reduction of your bone then at the same time the ULC's can be repositioned as needed.  Most likely grafts are not necessary.

Best Wishes,

Gary Horndeski, M.D.

Andrew Miller, MD · Answer

When a nasal fracture is reduced using osteotomies, the upper lateral cartilages do usually move with the bones as they are attached. However, after moving the bones, it's possible that the cartilage may still be crooked which might necessitate cartilage grafting to help straighten everything. That's why it's very important to see a rhinoplasty specialist for this procedure.

Ronald J. Edelson, MD · Answer

Some surgeons do cartilage grafts routinely and others don’t. I would probably not do a cartilage graft in your case. When you have a crooked nose it can be improved in most cases but there’s a strong possibility that it will not be perfectly straight.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photograph, you will need a rhinoplasty with placement of spreader grafts in order to straighten your nose. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Robert J. Chouake, MD · Answer

Hi,  Unless the nasal trauma was severe enough to cause the upper lateral cartilages to disarticulate (detach), they should naturally follow the bone when the fracture is reduced. Based on your picture, it seems unlikely that the trauma caused them to separate from the bone, but a thorough physical exam would confirm this. If the nasal fracture is being repaired through an open approach (as opposed to closed), the surgeon can also directly address any issues with the upper lateral cartilages during the procedure.

Mats Hagstrom, MD (license on probation) · Answer

The Cartlidge will usually follow the bone.
It depends if there’s other tissue holding the Cartlidge back.
It depends if someone has had previous surgery and many other variables.
I suggest scheduling a few in person consultations with plastic surgeons in your community who have extensive rhinoplasty experience.
Look for plastic surgeons who focus on rhinoplasty surgery, either exclusively or as a major part of their practice.
Look for provider who have at least one or two decades of experience with these procedures.
During in person consultations, ask providers to open up their portfolio and show you their entire collection of before and after pictures of previous patients who had similar characteristics.
 A lack of before, and after pictures should be a red flag that you may be not with the right provider.
In fracturing can be straightforward, but it can also be complex and there is no substitute for skill and experience.
I generally recommend having a few in person consultations before selecting a provider.
Best,
Mats Hagstrom MD

Do the ULC’s follow the bone in an open reduction of nasal fracture? (Photo)

Answers (7)

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