I had a nasal fracture occur and 3 days after the fracture I had a Closed Reduction done by a ENT Dr., now at 3 weeks post procedure I have a hard bump on the right side of my nose and a bump that has formed on my bridge and my nose looks crooked and my profile is awful. I spoke with the ENT Dr. regarding the appearance and he said it would need to heal for at least a month. What procedure can I expect for him to do next? Would Rasping be possible or would he need to break my nose again?
Nasal Fracture Closed Reduction Now Bump On My Bridge and Crooked, What Next?
Doctor Answers 12
Rhinoplasty after reduction of nasal fractures (broken nose)
- Sorry to hear that you broke your nose
The bone healing will form a callous of new bone that:
- feels like &
- Looks like a bump
- This will change over the next months as the nose heals
- some people believe in massage or "nasal exercises" to press on the bones while the heal, although this can be painful
- Be patient as it heals and wait for the swelling and healing to disappear.
- Then meet with your surgeon and discuss options (like rasping)
Nasal fracture and rhinoplasty
After trauma to the nose a closed reduction will align the nasal bones and correct the deformity. There will be swelling this can alter the appearance of the early result, and it can have an effect on the long term result and undo the good work of the closed reduction.
I agree with your ENT that now is not the time to act. Now is the time to wait and see the the final result mature and this may take more than a month. Once this swelling and healing has resolved it is time to see if a post traumatic rhinoplasty is needed and this may involved breaking the bones.
Only time will tell
Nasal fracture closed reduction
A closed reduction for a nasal fracture is usually the first step to try to get the nose midline and the bones in the right position. I always tell patients that they will probaly need a revision in 6 months to smooth out bumps etc..
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Problems after a closed reduction of a nasal fracture
Not an uncommon problem after closed reduction of a nasal fracture. The deviation of your nose could be due to a fracture of the nasal septum or a shifting of the nasal base to one side. Once the area has completely healed, 4 - 6 months, you may be a candidate for a rhinoplasty and possibly a septoplasty.
Closed reduction for nasal fracture is just a temporizing procedure
This is a very common scenario - revision rhinoplasty after closed reduction of a nasal fracture can be done safely a few months after the initial injury. I tend to wait a littler longer (6 months) to allow post-traumatic nasal swelling to subside completely.
Nasal fracture revision after closed reduction.
Nasal fracture revision after closed reduction will depend on what the nose looks like in 2 months. It will take that long for the immediate swelling to go down and then I would need to see your potos to give a proper answer. No surgery before that time.
Success of closed nasal reduction
Closed nasal reductions even in the best of hands have about a 60% success rate. The reasons for this are multifold but include swelling from the trauma that precludes accurate identification of all the contour and structural irregularities that are present in the nose. The nose may look straight after the initial reduction, but once the swelling resolves will reveal the underlying abnormalities.
Depending on the severity of the deformities that are present on your nose, you may need a formal rhinoplasty to satisfactorily address them. I would wait at least 3 months for your nose to adequately heal before pursuing additional surgery.
Issues after closed reduction of nasal fracture
Since you surgery is only 3 weeks after closed reduction, it's too early for any type of revision. Closed reduction is an useful treatment if your nasal fracture is significantly displaced or your breathing is affected by the fracture. It has limitation that it may not completely straighten your nose. It's common to require subsequent revision rhinoplasty for further improvement. I recommend that you wait at least 6 months before any surgical revision. Find a qualified plastic surgeon or facial plastic surgeon to help you achieve your goals.
Nasal Fracture and Closed Nasal Reduction
Closed reduction is performed to get the broken nasal bones back into their approximate normal position. It is thought best to do this before the bones heal solidly in the improper position. If the nose does not look aesthetically good after closed reduction then it is best to wait a few months to allow the nose to heal and then consider rhinoplasty. At that time, most likely the bump will be rasped down, and if needed osteotomies (breaking the nasal bones) performed. There is the possibility that over time your closed reduction will look better so that surgery may not be needed. Good luck and be well.
Michael A. Persky, MD
Crooked nose post closed reduction of nasal fracture
It is not uncommon to have some residual dissatisfaction after a closed reduction. That is because it was not broken where a plastic surgeon would for a rhinoplasty. Whether you could just have rasping or need the nose broken would require an examination by a plastic surgeon, or your ENT. Not all ENT's perform rhinoplasties regularly so you would want to confirm that yours does, if you are having him perform cosmetic changes to your nose.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.