Surgery Needed for Broken Nose and Slight Deviated Septum?

I broke my nose 5 days ago from an accident at home. I went to see a plastic surgeon today in NYC, found an MD on the net. I was told that I have a broken nose, and it's fractured with slight deviated septum. My nose is crooked a bit, but I can breathe fine. I just leave my noise alone. I am over 45 years old. Would I need to have a closed Rhinoplasty or Septoplasty?

Doctor Answers 14

Nasal Fracture

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A broken nose can cause block the airway. This can be the result of the broken bone or septum compromising the airway. An examination and possibly a CT scan can determine the extent of the fracture and deviation. From there your surgeon can suggest a plan which can include surgery. If your airway is not compromised then you can decide if you want a procedure to correct the external appearance of the fracture or deviation of the nose. Insurance often pays for the procedure if there is significant airway restriction. Often a cosmetic rhinoplasty can be performed at the same time. Insurance would not cover that portion so you would be responsible for that part of the procedure. Recover is generally 6 weeks and after an assessment you your surgeon. Best of luck. Dr. Michael Omidi

An in-person exam with a board-certified plastic surgeon is the best way to assess your needs and provide true medical advice.

Beverly Hills Plastic Surgeon
5.0 out of 5 stars 122 reviews

Nasal fracture repair

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Thank you for the question. If you have a mild deviation of the nose and/or septum, this can often be corrected in the first few days after the injury via a closed reduction. This procedure is done with topical numbing medications in many cases. If the fracture is "set" (not mobile), then a more involved septorhinoplasty would be needed. If you do not have any significant breathing problems, the decision to have this done would have more to do with cosmesis. Best of luck moving forward!

An acute nasal fracture should be treated in the first 2 weeks.

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Many times a broken nose can be moved back to its initial shape in the office under local anesthesia. The bones can be straightened and a further surgery prevented. If you can't tolerate this then you can have the repair with a higher level of anesthesia. Many emergency rooms and even some doctors will tell you to wait several weeks before getting an evaluation. This is wrong. If you wait then the bones will knit and you will need a formal rhinoplasty after 2 months. You will only need a septoplasty if the deviated nasal septum is causing difficulty with breathing. If you have trouble breathing you will want to see someone who is also trained in otolaryngology as a general plastic surgeon has limited training inside the nose. Again, don't wait more than 2 weeks to have an acute nasal fracture repaired.

Garrett H. Bennett, MD
Manhattan Facial Plastic Surgeon
4.5 out of 5 stars 8 reviews

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Broken nose and deviated septum

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If your breathing is good and the deviation is not concerning to you, you don't need surgery.  If your breathing is affected, a septoplasty may help you.  If you are interested, a rhinoplasty can straighten your nose.

Angela Sturm, MD
Houston Facial Plastic Surgeon

If you're breathing fine and your nose is straight on the outside, there is no need to have surgery.

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It is a good idea that you have gone to see a plastic surgeon after you broke your nose. It is important to make sure you do not have a septal hematoma. If your nose is indeed broken, displaced and crooked, it will need to be reset. This is performed through osteotomies of both nasal bones. This is technically not a rhinoplasty but a re-breaking and resetting of the nasal bones themselves. Most of the time when the nose is fractured the septum will be broken, twisted and deviated and should be repaired at the same time. It all depends on how twisted the septum is on the inside of the nose as to whether or not it needs to be fixed. If you are breathing fine and your nose is straight on the outside, there is no need to have any surgery. For many examples of rhinoplasty, and broken nose repair, please see the link below

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 reviews

Have the procedure only if you don't like what you see

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If you are breathing fine, then you shouldn't need a septoplasty. You can wait a few more days to let the swelling go down. If the nose is still crooked and this bothers you, then you can have the closed reduction to straighten the nose. If you don't mind how the nose looks and you are breathing well, then do nothing.

Parham Ganchi, PhD, MD
Wayne Plastic Surgeon
4.8 out of 5 stars 172 reviews

Your nose is what?

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If you're nose is broken and you're breathing okay, you don't have to get surgery! However, if your nose is crooked and you want it straightened, your surgery may involve putting the bones back to where they were (relatively simple with no incisions needed sometimes.) If you nose is very crooked, then you may require bone or cartilage grafts to help make your nose have a straight look. This is more involved and is usually done with an open approach. Good luck!

How to fix a broken nose

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Generally speaking, nasal fractures can be repaired at 2 time points.

The first is a procedure called a closed reduction, where no cuts are made and the bones are just pushed back into place. Generally, it is recommended to do this procedure within the first 7-10 days. I have done it as late as 3-4 weeks in severely deviated noses. This is often done with some light anesthesia to make it comfortable. Sometimes the septum will move over with the bones. Often it will not.

The second is a procedure more like a rhinoplasty, where the bones are rebroken and set in the middle. This is usually done after 3 months of healing has occurred. This definitely requires anesthesia.

Although some surgeons will try to do a septoplasty soon after an injury, I prefer to wait until the inflammation is gone. This allows more precise correction of the cartilage, in my opinion. Therefore, I tell patients they should wait 3 months to get their septum fixed.

For cases like yours, I generally recommend to have a closed reduction and then wait 3 months. If the breathing problems are still present, then a septoplasty can be done. Most patients feel better and don't need the second surgery for breathing.

Good luck

Richard W. Westreich, MD
Manhattan Facial Plastic Surgeon
4.9 out of 5 stars 55 reviews

It sounds like you need a closed reduction of your nose fracture.

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If your nose looks crooked after the trauma, but you're breathing fine, you should have this repaired. In general, you can have your nasal bones repositioned without "re-breaking" them within 10 days of your injury.

You can have a "closed reduction" of your nasal fracture performed with local anesthetic in the office, with minimal discomfort, and no downtime. If you wait longer than 2 weeks, you'll need a more extensive surgery with general anesthetic.

Since you're breathing fine, I don't think you need a septoplasty.

I hope this helps, and best regards.

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
4.9 out of 5 stars 435 reviews

Broken nose

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After an acute fracture, I usually discuss the options with patients. If the nose is significantly deviated, the goal of early reduction ( within the first week to 10 days) is to centralize the bony and septal complex as best as one can. Bumps on the nasal dorsum or revisions of slight deviations, will then have to be treated at about 6 months when the majority of swelling has subsided and the fractures are healed. If you go in acutely to do rasping of bumps, etc.. more damage than good can result. If the patient does not have significant deviation, then I would wait to treat the nose for at least 6 months. If the nose looks close to normal after the acute injury, then I would be inclined to leave it alone.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 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.