Fractured my nose 9 months ago. My nose was straight. Is this small bump permanent? What can I do about it? What is it? (Photo)

Question

9 months ago I was playing in left field during a softball game when someone had hit a fly ball so high in the air that it came down in a perfectly 90 degree angle onto my nose. It hit it perfectly in the middle, right where the bone on my nose starts. (Not the cartilage). I had swelling for 3 weeks but only had a small fracture. But now a small bump on my nose is the result. It's hard and literally feels like it sits on the bone of my nose. It looks so dramatic from a side view. What is it?

Nana N. Mizuguchi, MD, FACS · Answer

Hello. With any nose injury, it's a good idea to wait one full year before any decisions for correction are made because you could still be healing. But with injury like yours, it is a good idea to see a plastic surgeon now because there could still be a fracture which is causing the bump. If there is a permanent bump from injury after one year, Rhinoplasty is often used to correct nasal deformities. Your plan of care depends on the situation and your healing.  A plastic surgeon consult would guide you to more solutions. Have a great day.

John Michael Thomassen, MD · Answer

You fractured your nasal bones right where they meet the cartilage, the keystone area.  The separation of the cartilage from the bone has caused this stepoff.  To correct it you need a formal rhinoplasty with a cartilage graft to give you a straight dorsum again.

Stephen Prendiville, MD · Answer

Unfortunately, this bump is very likely to be permanent if still present 9 months after the injury.  The lining of the nasal bones, known as the periosteum, reacts to injury by producing more bone.  This will require surgery to correct.  It's best to have a consultation or two with an experienced Rhinoplasty Surgeon to give you further information.

Jamil Ahmad, MD · Answer

Unfortunately, it appears that you have a posttraumatic deformity of your nose. After breaking your nose, the bones appear to have healed in a way that has created a bump. At 9 months, enough time has passed for the swelling to resolve and what you are now seeing is likely permanent. If you are unhappy with the appearance, you should see a board certified plastic surgeon to see what options you have to improve this area.

Mark Hamilton, MD · Answer

Unfortunately nasal trauma and fractures can lead to deformities like this. By 9 months, you would expect pretty much all of the swelling to be gone; so unfortunately you most likely will need surgical correction.The first step would be to meet with a facial plastic surgeon who regularly performs nasal surgery for a full examination and thorough discussion of your options.

Stephen Weber MD, FACS · Answer

It does look like a bony callous has formed and is creating that bump. Since it is present nine months later there is a strong possibility that it will not resolve with further healing. I would recommend consulting with a rhinoplasty expert to discuss your options. If this is your only concern, then the bump can be shaved down without making any other changes to your nose. I hope this information is helpful for you.Stephen Weber MD, FACSDenver Facial Plastic Surgeon

William Portuese, MD · Answer

Trauma to the nose can create a displaced nasal fracture, a non--displaced nasal fracture, a fracture of the septum (also knows a deviated nasal septum), and fracture the upper lateral cartilages off of the nasal bones. To determine the extent of the injury, its best to seek out a consultation with  a board-certified ENT/ facial plastic surgeon to examine the internal and external portion of the nose. The dorsal hump that is present  is composed of both bone and cartilage and must be shaved down in order to remove it. Osteotomies of the nasal bones are then required to straighten the  bridge line and reduce the nasal fracture. Cartilage grafting techniques may also be required. For many examples of broken nose repair in our practice, please see link and video below

Robert Singer, MD · Answer

An injury to the nose often produces a swelling and lump on
the bridge of the nose, which usually diminishes with time. If it persists
after 9 months, it is probably a result of formation of callus or scarring of
the underlying bone from the trauma and is most likely permanent. It can be cosmetically improved with an artistically performed natural appearing rhinoplasty through a closed approach.

Keep in mind that following advice from a surgeon on this or
any other website who proposes to tell you what to do based on two dimensional
photos without examining you, physically feeling your tissue, assessing your
desired outcome, taking a full medical history and discussing the pros and cons
of each operative procedure would not be in your best surgery. If it concerns
you I would suggest that you find a surgeon certified by the American Board of American Plastic Surgery and one who is ideally a
member of The American Society for Aesthetic Plastic Surgery (ASAPS) or a
facial plastic surgeon (otolaryngologist) that you trust and are comfortable with. You should
discuss your concerns with that surgeon in person.

Robert Singer, M.D., FACS

La
   Jolla, California

Darryl J. Blinski, MD · Answer

Could be callus formation in the nasal bones. Only surgery of file technique can removed it. seek in person opinions......

Robert S. Schmidt, MD · Answer

Thanks for your question. Softball is fun, but this sort of thing can happen. When bones are fractured, they heal by forming a callous, just like people get on their hands and feet. This callous remodels and hardens into new bone. In some people, the callous gets rather large and leaves a bump like yours. A rhinoplasty can be necessary to remove the hump. Usually this can be done with an incision inside your nostril and without outside scarring. If you were having breathing issues from the accident, these could be addressed at the same time. I'd visit with a local facial plastic surgeon who is comfortable with reconstructive rhinoplasty. Depending on your policy, insurance may cover some of the cost of the surgery. Good luck!

Fractured my nose 9 months ago. My nose was straight. Is this small bump permanent? What can I do about it? What is it? (Photo)

Answers (11)

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