Pain 5 Months Post Closed Nasal Fracture Reduction?

Question

I fractured my nose 5 months ago. I received a closed nasal fracture reduction 14 days after the trauma by a facial plastic surgeon. After the cast was removed, we found that the bone still felt displaced (like a divot), but you cannot see it, aesthetically speaking my nose looks fine, surgeon said this was ok. However, 5 months later I still have significant pain in the area. It hurts to wear glasses and when I stretch my face (like how women put on mascara, or stretch down upper lip).

Kenneth Hughes, MD · Answer

Hard to answer this one without an exam.  If there is no contour deformity and no palpable irregularity, it would be difficult to recommend surgery.  Kenneth Hughes, MD Los Angeles, CA

Pablo Prichard, MD · Answer

Dear Sue,

	Thank you for your question.  If you have a bump that you can see but not feel, then this may be a sharp shard of bone that is poking into your tissue.  When you pull your skin over it, the point of the bone may dig into the tissue causing pain, much like bone spur.  A Rhinoplasty, with filing this area down may be best.

	Best Wishes,

	Pablo Prichard, MD

Douglas J. Mackenzie, MD · Answer

A revision rhinoplasty may help. You may have a nonunion of the nasal bones which means that they didn't heal together. So when eyeglasses rest on them, or facial movement moves them slightly, you get pain.

Kristina Tansavatdi, MD · Answer

Pain after surgery can sometimes be due to formation of neuroma or sensitive nerve fibers at the site of the injury that are still healing. Revision surgery should not be considered as a end-all cure for your pain. The pain may continue to lessen at the site over the next 6 months to 1 year. If the results are aesthetically pleasing then I would not rush into revision surgery. In some cases, however, there can be improvement with further surgery at the site but this is uncommon. One option to reduce pain at the site in the interim is to ask your surgeon to perform a mixture of steroid/anesthetic injection to the area that is bothering you to see if that will help decrease the pain.

Vincent D. Lepore, MD (retired) · Answer

If you are still having pain 5 months after a closed nasal fracture reduction and the nasal bone still feels displaced, you may be a candidate for a revisionary rhinoplasty. Check with your surgeon and ask what the treatment options are in your case. Best wishes.

Robert E. Zaworski, MD (retired) · Answer

Answering this question requires an exam. Based on the information given, it sounds like you need revision surgery. Consult with a Board Certified Plastic Surgeon who has a lot of experience in nasal surgery. Best wishes!

Pain 5 Months Post Closed Nasal Fracture Reduction?

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