Nose Blow Left a Dent on the Right Side of Nose

3 weeks ago, I received a blow to the right (left to you) side of my nose. Upon touch,I could hear some crackling, which is gone now. No bleeding but there was pain & swelling. I noticed a discolored dent. It looked and still looks like as if someone left a fingerprint mark on my nose, and it makes my nose look crooked (looks only smudgy in pics). It hurts if I apply pressure to it. Is this dent permanent or will the tissues in the area repair themselves & fill it up? How can I fix this? Thanks!

Doctor Answers 4

Dent on side of nose from trauma

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When the nose bones are fractured, it is often obvious, as the nose appears quite crooked.  This becomes more apparent as the swelling subsides. When one side is pushed in at the mid-third of the nose, it is because the upper lateral cartilage has been dislocated and fractured off the nasal bone due to trauma.  Without treatment the nose will remain crooked permanently.  The best treatment is nasal surgery with a spreader graft, which is composed of the patient’s own nasal cartilage taken from the nasal septum.  This graft is then inserted up underneath the upper lateral cartilage to reestablish structural integrity to the area.  

Seattle Facial Plastic Surgeon
4.8 out of 5 stars 157 reviews

Dent in the nose...

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Nasal trauma, with enough force, can cause lasting changes in the appearance of the nose.  Typically, a cracking sound indicates that the nasal bones, or nasal cartilages have shifted in position.  The initial treatment, within approximately 7 days, is a closed reduction, where the bone/cartilage can be shifted back into position.  If there is still a change in the appearance, a rhinoplasty may be required to improve the contour.  Swelling in the nose can last several weeks, and therefore it makes sense to wait a little while to decide whether you need an operation or not.

Xerxes Punthakee, MD
Toronto Facial Plastic Surgeon

Broken nose

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From your posted photos it looks like the blow caught the bottom part of the nasal bone and also may have pushed the septum slightly to your left side. This deviation will not go away by itself. If you treat these early after the injury (within the first week) the bone fragments can be pushed back into place. After that they stick together and heal in their new position. The bone here is thin so rebreaking it after the pieces have stuck together is unpredictable and usually not recommended. Since this small degree of inward movement of the bone usually does not affect airflow the usual late treatment is camouflage with crushed or bruised cartilage. The cartilage is harvested from elsewhere in the nose or from the ear and inserted from the inside of the nose to fill the concave indent. Depending on the degree of septal deviation the septum may also require some work. The important thing to do is get the injury and its result documented in your medical records so that if you decide to get something done it is covered by your health insurance.

I hope you realize that this format of posting questions and receiving answers lacks the face to face direct communication required for you to make an informed decision regarding your surgery.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Aaron Stone, MD
Los Angeles Plastic Surgeon

Nasal injury and depressed area

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From your photos it looks like there is a depression of the middle third of your nose on your right side. This could reflect an injury to the upper lateral cartilage; that might have been the noise you heard when the nose was injured. It seems that this cartilage has been pushed in and perhaps separated from the nasal bone. Best to wait a while longer to be sure that all the swelling from the injury has gone away first. Then see a surgeon to evaluate your nose. You might need a spreader graft to hold up the cartilage or an onlay to camouflage the depression. The darkness could either be a shadow cast by the depression or a deep bruise.

Russell W. H. Kridel, MD
Houston Facial Plastic Surgeon
4.3 out of 5 stars 15 reviews

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.