Rhinoplasty After Recent Closed Reduction?

Hi Jotex,
Although rhinoplasty surgery may be necessary after a closed reduction for nasal fracture, one week is way to early to tell.
Generally, the stages of healing in the nasal bone involove swelling, and "callus" that is necessary to get the bone to stick toghether again. This results in the appearance of a bump in the bridge that will generally go away after a remodeling period of a few months.
There are occasions, however, when a rhinion deformity or a permanent bump on the bridge can develop after nasal fracture reduction. This type of deformity, along with some others that may develop after nasal fracture may require surgery to correct.
I generally have patients wait for 6 months to ensure that remodelling has begun and almost resolved. The healed bones will never reach their full 100% strength. For this reason, reshaping of the bridge using controlled fractures may be diffucult during surgery. The waiting period of 6 months also helps to ensure that sufficient strength has been attained in the bones prior to attempting re-shaping.
Good luck, and be patient -- you may not need surgery in the end.
Dr. T

It is impossible to tell without an examination whether the hump will be permanent or whether it is due to swelling at this point. You should wait at least 3 months after the closed reduction to assess the situation. If it is getting better at that point then wait longer. If it is not then you can consider rhinoplasty. Rhinoplasty is not more difficult after closed reduction from a scarring point of view, but if the nose is now crooked it will be more difficult that if it were straight.

 It is too soon to know how the nose will look. Wait 6 months and if it still bothers you then have a rhinoplasty. It may be perfectly fine without any further surgery.

Hi Joe,
Be patient and wait to see if the bump resolves. The main purpose of a closed reduction is to get the nasal bones realigned in the center of your face.
If the nose continues to bother you either cosmetically or functionally (breathing difficulties) after 6 months then open rhinoplasty would be indicated.
After a nasal fracture, natural healing forces and scarring continue for a few months. It is best to let these forces settle down before performing rhinoplasty to give you the best chance of getting it right the first time. By waiting for healing to take place, the surgery should not be "more difficult".
Plus, by waiting you may find that the bump will resolve and you will not need surgery at all.
You will be able to find plenty of surgeons who are willing to operate on you tomorrow, can you say $$$; my advice would be to wait. Choose your rhinoplasty surgeon carefully.
Good luck and be well.
Dr. P

The type of swelling that you are describing is not unusual and all and is in fact very common. The bone must heal and a callus formation is necessary. You willl notice many changes in the shape and feel of your nose over the next 3 - 6 months. If the bump persists after this time then a more formal hump or dorsal reduction may be needed.

But it doesn't have to be 6 months if the deformity is obvious and a clear answer to treating it is apparent. The bump of your nose if soft could be swelling that will go down. If it is hard, it will probably be less likely go down.
The nasal bridge is an area that I believe will need less waiting time than compared to the nasal tip and the area around it and a little more superior to it. This is something that can more easily be approached and treated so don't worry. You are going to do great!!

Full healing of your fracture needs to happen before any attempts at corrective rhinoplasty. I would have you wait at least 6 months, and preferably one year. That way you are ensured that any new fracture done by the surgeon will not crack along the old fracture line.
For now, wait for all the swelling to go down and re-evaluate at 6 months. Have a plan outlined with your surgeon and that will help you with the waiting period. Best of luck.

Haste makes for poor results. You need to wait 3 to 6 months before contemplating any changes to your nose. The bump may go down. Let the bones heal and then deal with the problem. Make sure you see an experienced nasal surgeon. If it is only a bump it can be easily fixed with a closed rhinoplasty.

Generally in our practice , we will wait until bony healing is virtually complete from a closed reduction before we attempt any type of open reduction or rhinoplasty.  That will also allow time to make sure that any swelling is gone and that the open reduction is really needed.

Yes, this could represent swelling. You should ask your surgeon if it is permissable to massage the area gently, as this often assists in resolution of localized edema. After fracture and closed reduction irregularities may persist and require operative correction. It is best to wait at least 6 months to allow maximal tissue and bone stabilization. At this point correction can be underatken in the most predictable and accurate fashion. Indeed, rhinoplasty after fracture and previous manipulation can be more difficult but still very feasible.
Hope this helps!