Why is my nose still off center after a closed reduction?

It is simply too early to make a judgement about the final result.   Pictures would be helpful to make an assessment.Kenneth Hughes, MDLos Angeles, CA.

By my calculation, you broke your nose 2 weeks ago, you had surgery 10 days later and now your splint fell off 3-4 days after surgery and it still looks crooked. First of all, let your doctor know ASAP that the splint came off, since we usually like it to be in place for a week. Second, noses swell after surgery, and that swelling is not symmetric, so it may look crooked, but it is actually just swelling. If your nose is swollen and stuffy inside, it is likely swollen on the outside. Be patient with the healing and let your doctor know about the splint!

Closed reductions are usually done while there is still some swelling in the nose from trauma. Thus, they are an attempt to get the nose straighter, but not usually as accurate or precise as osteotomies in elective rhinoplasty. You should definitely check with your doctor to see if he/she is satisfied with your progress at this point. Your options would then be to go in now and correct something if there is an obvious problem, or wait and see how the nose heals. In my practice I have patient wait a year after closed reduction before considering a definitive rhinoplasty. Remember, there is no such thing as a perfect nose, just one that suits your face well. I hope this helps. Good luck. MG

Closed reduction can fail in some cases. If the bones are totally mobilized or the fracture is repaired late or the splint comes off to soon the bones can gravitate toward their injured position. With that said your nasal obstruction could result from swelling inside your nose. You should contact your ENT immediately to let them know the splint fell off and have them evaluate the shape and contour of your nose. I hope this information is helpful for you.Stephen Weber MD, FACSDenver Facial Plastic Surgeon

Hiyou broke your nose. A closed reduction is an "attempt" to improve the nose but it does not erase the damage. At times a closed reduction can put the nose almost back to where it was but often it is not 100% successful due to the kind of damage.  Hopefully it improved it a bit at least. Also many times the nose was not perfectly straight to start with but this may have gone unnoticed till now.  A good closed reduction is the first step but you may require a more definitive septorhinoplasty in the future. 

There is no guarantee that a closed manipulation of a fractured nose will restore complete symmetry or return the nose to its original shape. At best it is an attempt to straighten and realign the nose and relies on there being enough inherent stability in the fragments of bone and cartilage for them to retain their alignment when repositioned. The the nose was shattered in the first instance then the fragments are likely to be small and unstable. It takes several weeks for the pieces to "knit" back together and during this time the nose is very vulnerable to moving out of position with minor trauma. If your nose isn't straight after the attempt at reduction then you should discuss this with your surgeon promptly especially if there has been more trauma