If a nose has been broken is there always visible damage or scarring?

The only way to determine if a nose has been broken is to have an exam with possible imaging. Kenneth Hughes, MDLos Angeles, CA

A "broken nose" refers to when part of the nasal bones are cracked or move. Or sometimes the entire bony "pyramid" can shift. These bony changes can be seen on X-rays. The nasal bones only comprise about 1/3 of the length of the nose however, and the remaining parts which are made up of cartilage can also be dislodged or broken, although these would not necessarily show up on X-rays. Most trauma to the nose is blunt and doesn't break the skin. Initially there will be swelling and that acute swelling might mask any subtle changes and prevent us from appreciating them initially. Only after the swelling subsides are we usually able to detect the changes but it is possible that there will be little or no visible damage. A non-displaced fracture may not result in any demonstrable change, not might a subtle shift of the pyramid. Most commonly the visibile changes become apparent only after 6-8 weeks when swelling has subsided. there might be a curve to the septum or a depression along one of the side walls from an uppper lateral cartilage mvoing inwards. The bones might have a different slope as they move from the bridge to the junction with the face. There might even be some flattening or a "dent". Even if there are not any external changes the inside of the nose might be quite different as a result of the trauma. The septum might be deviated or the side walls might be collapsed and either of these might cause signifcant breathing problems. The best plan of action after a "broken nose" or any nasal trauma would be to ice it and take anti inflammatory medicines and to have an evaluation so that the trauma can be documented for inusrance purposes and any indicated treatment rendered. I ususally wait approximately 8 weeks before re evaluating things unless the nose is extremely twisted and the bones are mobile; in which case I might perform a "closed reduction" by manipulating them into a straight position within a 10 day period before they begin to become fixed. While a closed reduction might help to straighten things it is very limited in what it can ultimately achieve and may even need to be followed eventually by a more comprehensive rhinoplasty to deal with the cartilage etc..

It is possible to break your nose and not have any visible deformity of the nose or external scarring. Most often, a severe break will cause some shifting of the nose to one side or the other or, possibly, flattening of the nasal bridge. An ENT or Facial Plastic Surgeon can easily evaluate your nose to let you know if your nose is broken and advise whether any treatment is indicated. I hope this information is helpful.Stephen Weber MD, FACSWeber Facial Plastic Surgery

A broken nose Can have many variabilities due to the trauma that occurs. If the nose bones are be broken and displaced than they will need to be reset. If the nasal bones are have been non-displaced , then you will not need any surgery. In addition the upper lateral cartilages could also be fractured off the nasal bones creating a concavity in the mid third of the nose which can also lead to nasal obstruction internally. A septal fracture usually occurs with a significant nasal fracture and a deviated septum will need to be repaired simultaneously.

It depends of how badly the nose was broken. If the bones were broken, but not displaced, usually the nose heals with little to no visible signs. Notice I said usually. Everyone and every broken nose is different. Badly broken and displaced noses are much more likely to have residual lumps, bumps, and scarring. If there is a cut on the nasal skin, it will leave a visible scar.

An exam is needed to determine if your nose has been broken. Consult with a Board Certified Plastic Surgeon to discuss your concerns.