What are the signs and symptoms of a broken nose?

Here is my take on broken noses:  A nose can be technically broken but not have outward or inward deformity and not cause any cosmetic or functional change:   You look the same (after the swelling goes down in a week) and you have no change in nasal breathing.  Thus, regardless of an x-ray finding, nothing needs to be done.  If there is an obvious deformity or difficulty breathing after a week, then further treatment is indicated. 
 

It can sometimes be difficult to tell if you've suffered a broken nose. Some of the tell tale symptoms include fairly significant pain and continued tenderness for days after the initial injury, bruising of the area, a bloody nose, increased nasal congestion, or hearing/feeling a loud pop or crack during the initial trauma. Any visible external changes to the upper third of the nose can also indicate a fracture. Sometimes, if the fracture is significant enough, you can actually feel some of the bones moving when you palpate the area. If you are seen in the ER or urgent care, they will frequently order an xray or other scan of the nose which can confirm the diagnosis.
One thing I always remind patients with any concern for a broken nose, is get in to see someone that can manage this within around 5-10 days after the injury. This includes Facial Plastic Surgeons, Plastic Surgeons, or most ENTs. After about 14 days, the bones will heal and fuse in their current position and if they are misaligned, they will be unable to be addressed without going to the OR and "rebreaking" the bones.
Hope this helps! Kyle Kimura, MD

Hello, thanks for the great question!
Signs and symptoms of a broken nose include: tenderness to touch, new deviation or any change to the shape of the nose, swelling, bruising, bleeding, change to your ability to breath through the nose, and black and blue eyes. The first thing to do in a situation in which you believe the nose may have been broken is to hold pressure if there is heavy bleeding and to head to the closest nasal specialist near you, which includes ENT doctors and plastic surgeons. If there are no specialists available, the next best place to go is to the emergency room. A trained professional should perform a complete head and neck exam to determine in the nasal bones are fractures. Typically imaging is not required for diagnosis. If the bones are in fact broken, they should suggest either immediate reduction or a delayed reduction sometime within the next few days to weeks.
Hope this helps!
Best,
Dr. G
Dominick J Gadaleta, MDFacial Plastic SurgeonDG Facial Plastic SurgeryPalo Alto, CA

The clinical symptoms of a broken nose after a nose trauma or accident are:  bleeding, swelling, bruising around the eyes, deformity such as a crooked nose, or flat nose, difficulty breathing and some times pain.  My advise is to go immediatly to an emergency room to be examined and have some x rays and CT scans taken and if possible having your nose taken care that same day

The most obvious sign of a broken nose is crockedness. This can be difficult to see early after the injury becase of swelling. Bruising (black eyes), a nose bleed at the time of the injury are also suggestive of a break. However, swelling can make it difficult to evaluate for a break, so it's always best to see a qualified physician to evaluate the injuryt. If you have severe pain inside the nose and blockage of nasal breathing, an injury called a septal hematoma is possible. In that case seek medical attention right away. Thanks for your question. 

Any traumatic nasal injury can cause the following:
Bleeding
Swelling
Change in the shape of your nose
Septal Haematoma (blood collection in the septum) - this needs to be dealt with urgently

I would suggest seeing an ENT/nasal surgeon as soon as this has occurred to ensure there are no acute complications that need addressing eg. Haematoma. If there is an obvious deformity, this needs to addressed within 2 weeks via a simple manipulation of the nasal bones. Any longer and you will require a formal rhino/septorhinoplasty.

If you have sustained trauma to your nose and are concerned that you may have broken your nose I recommend that you seek the care of a Board Certified Facial Plastic Surgeon.  
Signs and symptoms of a broken nose can include but are not limited to:
Nasal bleeding after injury
Sustained nasal pain after injury
Change in nasal shape
Change in ability to breathe

Some of the most common symptoms of a broken nose include pain, bleeding, bruising, swelling, nasal obstruction (feeling like you cannot breathe out of your nose properly). If you have any of these symptoms, especially after experiencing some sort of trauma to the face, I suggest you see a board certified facial plastic surgeon right away. 


Gary Linkov, MD
Rhinoplasty Specialist
Manhattan

This is a good question that my staff has to answer on phone calls and emails almost daily. I you just have swelling your nose may or may not be broken--probably not. But if you have black and blue lower lids and nasal bleeding then there is a strong possibility of a nasal fracture. Of course if the nose is shifted off the midline or depressed then there is no doubt. Nasal airway obstruction could indicate a deviation of the septum as well a fracture.
I typical don't x-ray the nose as my exam is more accurate. If your nose is straight with swelling, I wait a week and reexamine to see if the fracture is then visible or palpable, before deciding on a treatment plan.

When we are talking about a broken nose, we generally talk about fracture of the nasal bones and nasal septum. The signs of a broken nose are not specific, other than the ones visible on an X-ray, which is also what confirms the diagnosis of a broken nose. We can talk about two "situations" when it comes to a broken nose:
1. A FRESH TRAUMA or immediate injury in its acute state, which is usually followed by swelling, pain, bleeding, asymmetry of the nose, possible difficulties breathing through the nose, visible fracture on the X-ray and other symptoms related to such acute injury. A repositioning of the nasal bones is best to do immediately after the trauma/injury. In case several days go by and the healing process is already significantly advanced, it is recommended to wait a minimum of 6 months to undergo a nose correction. 
2. OLD INJURY (years after the trauma),where the usual signs are a crooked nose, asymmetry, a more or less visible bump on the nose, thickening of the boney parts, possible difficulties breathing through the nose, a significant posttraumatic deviation of the frontal part of the nasal septum. All of this can be corrected with an aesthetic and functional procedure if needed.

Trauma to the nose can be complex - we see a variety of injuries on a near daily basis, both in my NHS and Private practices.
Generally, there will be swelling and bruising around the nose and eye region and the nose may be displaced to one side or the other.  Patients normally feel their nose gets blocked after an injury but this may just be swelling initially, although can indicate internal injury.
It will depend a lot on how the injury occurred and which part of the nose took the most force.  A "Friday night punch" type injury may cause the bridge of the nose to move to one side, for example, whereas falling straight onto the nose, will often flatten the bridge area making it look wider.
I spend a lot of time examining nasal injuries as they need a lot of careful analysis to advise about the best way of correction, including endoscopic examination of the inside of the nose to check any septal deformities.