Results of Rhinoplasty for Curved Nose?

I got punched on the side of the nose and from that, the nasal bone was obviously decompressed on one side. It also made an obvious curve or slat. The surgeon performed a closed reduction Rhinoplasty. With surgery, I had packing in the injured side and a splint on top. I just got the splint removed, but the curve still looks pretty apparent to me. Is it too soon to freak out? Will the straightening settle in? Was there something else that the surgeon should have done in order to straighten the curve other than closed reduction?

Doctor Answers 4

Rhinoplasty...Closed Nasal Reduction versus Open After Trauma

Aloha Tobimia,

Watch out for those left hooks!

A closed reduction of depressed fractured nasal bones is usually performed immediately before swelling occurs, or in the great majority of cases 5-7 days following the trauma to allow for swelling to resolve.

The closed reduction is performed to attempt to align the nasal bones, and to avoid having the nasal bones heal extremely crooked (in which case the bones are very difficult to reset).

In many cases the closed reduction is all that a patient may need.
Studies have shown that open reduction of the crooked nose is best performed about 4 to 6 months after the initial trauma so that all dynamic healing forces have settled and will not affect the surgical healing.

Your closed reduction likely moved your bones into a better position, but your nose still appears crooked. No need to "freak out", but you may require an open rhinoplasty procedure in a few months.

Discuss this with your rhinoplasty surgeon, and please take a swim for me in your beautiful Hawaiian Island waters.

Good luck and be well.

Dr. P

Encino Facial Plastic Surgeon
4.8 out of 5 stars 36 reviews

Middle vault collapse after Rhinoplasty

Although it seems that you probably had some amount of saddle deformity (weakness to your profile) prior to the injury, it is quite apparent that you now have a depression on the right side in the area of the middle third of your nose. This depression is the result of collapse of the attachments of the right upper lateral cartilage that give it integrity. This depression will also make your nose look curved, but most importantly it will affect your breathing out of the right nostril. The closed reduction you had, will not correct this problem.

When a patient walks into my office with your problem, I advise them to wait at least 6 weeks to allow the swelling to resolve and then we can consider the appropriate treatments to correct your problems. These treatments may include 1- spreader grafts to correct the curve, middle vault collapse as well as the airway deficiencies. You may also be interested in improving the saddle deformity.

Robert M. Freund, MD
New York Plastic Surgeon
4.8 out of 5 stars 33 reviews

It is best for you to wait to judge this.

It is too soon to say. Go back to your surgeon and have him give you a better evaluation than we can. If it is still deviated after the swelling goes down, you will need it redone.

Sometimes the septum is holding the bone over and it redeviates. If you have any concern after you see your doctor, get a second opinion from a rhinoplasty specialist.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 34 reviews

Persistent irregularity after surgery for nasal trauma injury

Generally most surgeons avoid major surgery when a closed reduction is performed unless the injury is open and associated with major displacement.

You have undergone accepted treatment and yes your nose may still be deviated. However, most surgeons would not recommend a more agressive approach at this point in time. Sometimes the bones can be properly set but the cartilage remains displaced or depressed and this oftentimes is a more difficult problem to treat.

At this point in time, the goal is to let your wounds and bones heal. It may be that definitive treatment and optimal correction of your injury requires more surgery in the future. Frequently the correction of nasal deflection/deviation/irregularities require techniques where the deformity is camouflaged by placement of grafts.

Alternatively, it could be that normal swelling and scarring may be creating the illlusion of persistent deformity which may improve over time.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 81 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.