Is It Possible to Make a Mildly Fractured Nose Straight As It Was Before?

Question

I was punched in the face and my nose is mildly fractured. It is no longer straight & it has a slight curve to it. I guess its not too noticeable to most-if they're not lying to me, but noticeable if I point it out. Its been 1.5 weeks now.  I know I have to do this soon for the best results. Whats the longest I can wait?  What type of plastic surgeon is best for me? Rhinoplasty plastic surgeon? ENT?  & how much should I pay to get my nose reconstructed exactly the way it was before? Is that possible?

Kevin M. Robertson, MD, FACS · Answer

I think you can see from other surgeons that you need to move on this as early as possible.  The body often displays memory, so a long standing deviation is harder to correct that recent trauma.  Also, from a practical matter, some insurance companies have time limits on what they still consider "reconstructive."  If you are outside of that window, or are deemed cosmetic, than the fees vary by geography, complexity, and surgeon. 

	The discipline of the physician is not as important as their experience.  Seek out a surgeon who does a lot of nose procedures.  Nasal surgery is often described as one of the toughest surgeries to consistently get perfect results, and in my opinion, complete correction of a crooked nose is one of the reasons why.  The predictability of the final result can be challenging, even in the best of hands.

Farbod Esmailian, MD · Answer

After trauma you have a window of about 2-3 weeks to have a closed reduction rhinoplasty to try to straighten the nose.  In 50% of cases the patient will need a formal rhinoplasty after 1 year out from the injury.

	Good luck.

Sam Naficy, MD, FACS · Answer

Better to see a rhinoplasty surgeon sooner than later.  Most decent insurance companies cover the cost, especially if there are breathing problems along with the fracture.

Michael A. Persky, MD · Answer

Hi Dak,
Best to see a rhinoplasty specialist asap!  You can see a facial plastic surgeon, ENT, or general plastic surgeon.  The nasal bones are best reset within 5 to 18 days of the injury.  The longer that you wait, the more difficult to reset the bones.  If treated early, a closed nasal reduction (no incisions, under local anesthesia in the office, or in the operating room) is performed.  If you wait longer, then an open reduction which is more involved is required.  Costs vary, but it is much less if you have a closed reduction under local anesthesia in the rhinoplasty surgeon's office.
Good luck on a straight nose.  Be well.
Dr. P

William Portuese, MD · Answer

It is a good idea to try to fix the nose within the first month after the injury because the nose will have memory of wanting to be straight again. If you wait after six months the memory of the bone and cartilage will want to be crooked and you will have a higher incidence of needing it revised. The nose bones can be straightened and the curvatures removed and reconstructed to its pre-injury condition. This is usually covered under medical insurance as long as the accident has been documented with an x-ray and pictures. Changing the nose shape would be a rhinoplasty, which is only covered by the patient through cosmetic surgery. Look for a board-certified facial plastic surgeon that has performed thousands of rhinoplasty surgeries to give you the best results. An ENT doctor who performs lots of facial cosmetic surgery would be a good option for you. The average cost of a rhinoplasty is $6,000, which includes the operating room, anesthesia, and the surgeon’s fee for performing the rhinoplasty.

Raghu Athre, MD · Answer

There are many options to fix a broken nose. If the fracture occurred recently, but closed reduction is possible. The term recent is variable depending on the patient. For most healthy adults this time period is probably within seven days following the injury.   Following 7 to 8 days after the injury, the bones have already started healing themselves in the crooked fashion. Once this is occurred, it makes it very difficult to get a straight nose with using simply a closed reduction technique.

	Therefore, it is necessary  to utilize an open technique or a full rhinoplasty once the nasal bones have already started healing.   It is very important to find a surgeon who is extremely adept at rhinoplasty. Facial plastic surgeons have some of the highest level of experience in rhinoplasty techniques, but there are also plastic surgeons who do excellent rhinoplasty as well. the most important factor is to be comfortable with your surgeon, see his or her pre-and postoperative results, and check to see that they are board-certified.

	Costs for rhinoplasty vary immensely. A rough estimate for an open rhinoplasty it's somewhere within the $4-$5000 range. However, some surgeons charge as much as $7-$12,000 for a primary rhinoplasty. The price varies also with respect to the geography.

Darryl J. Blinski, MD · Answer

Yes, of course. But do it soon as possible before additional healing can occur. Seek out three boarded PS to evaluate your injury of the nose.

	From MIAMI Dr. B

William B. Rosenblatt, MD · Answer

Time is running out -- it needs to be done within 3 weeks so quickly go see a surgeon who does rhinoplasties -- either an ENT or a Plastic Surgeon.

Samson Lee, MD · Answer

A closed nasal reduction is a procedure to straighten nasal bones that have been fractured. This can only be done about 2 weeks after the injury, after 2 weeks the bones will have started to heal and you will need to rebreak them to reset them in the correct position. Most surgeons after 2 weeks would have you wait 3-6 months before considering doing this. It is also possible that you may have fractured the cartilaginous septum in your nose, if this is the case, a closed nasal reduction will not work and a rhinoplasty will be required.

Edward J. Domanskis, MD (in memoriam) · Answer

If it is not straightened after a traumatic injury within about one week, it usually will stay crooked. It is difficult to say whether you will be able to get it straight. I would say probably not. Fortunately, in a male, a straight nose is not critical.

Is It Possible to Make a Mildly Fractured Nose Straight As It Was Before?

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