Shave or break nasal bones?

Usually, if the nose is wide and crooked, multiple maneuvers will be required.Find a plastic surgeon with ELITE credentials who performs hundreds
of rhinoplasties and rhinoplasty revisions each year. Then look at the
plastic surgeon's website before and after photo galleries to get a
sense of who can deliver the results. Kenneth Hughes, MD Los Angeles, CA

if the the bones are crooked then they need to be broken to  straighten  them. If they r straight then they do not!

To adequately narrow your nasal bones, fracturing would be the most predicable result and outcome. However, a tiny bump on the nose can be shaved or rasped down, but if it is large, it must be fractured off using a chisel.

The hump on the bridge line can be shaved down, however the nasal bones must be broken  with medial and lateral osteotomies to narrow and straighten the nasal bones. A cartilaginous spreader graft may also be needed in the mid vault area of the nose which can be placed underneath the concave upper lateral cartilage.  Look for a very experienced rhinoplasty surgeon for best results.

When the nasal bony pyramid is struck straight on, the fracture may cause widening of the bridge with curvature. This is usually not treatable with filing or "shaving". In order to restore the narrower width and straighten the dorsum, osteotomies (precise splitting of the the nasal bones with a fine chisel) is necessary.

There are different approaches that can produce good results. The choice of the surgical echnique depends on multiple factors including your anatomical findings, desired outcome and the plastic surgeon's expertise and experience.Following the advice from a surgeon on
this or any other website who proposes to tell you what to do without examining
you, physically feeling the tissue, assessing your desired outcome, taking a
full medical history, and discussing the pros and cons of the operative
procedure would not be in your best interest. I would suggest you find a
plastic surgeon with extensive nasal surgery experience who is certified by the
American Board of Plastic Surgery and ideally a member of the American Society
for Aesthetic Plastic Surgery (ASAPS) or a facial plastic surgeon that you
trust and are comfortable with. You should discuss your concerns with that
surgeon in person.Robert Singer, MD FACSLa Jolla, California

Usually to straighten a crooked nose, osteotomies are required. This does involve "breaking" the delicate nasal bones during surgery. It is tempting to think that the bones can just be shaved down creating a natural contour but this is rarely adequate especially in cases where the bones need to be cut and reset.

It is hard to give you actual advice without a thorough consultation or pictures to review. However, from what you have described with the appearance of a crooked nose and history of nasal trauma there is a likelihood that the bones would have to be re-broken. If the nasal bones are not off midline then a shave could be appropriate as well with cartilage grafts (onlay) used to straighten the nose. Any advice here would be inappropriate to make your final decision. I would seek out one more surgeon for an in-person consultation before you make your decision.

This depends on the current appearance and location of the fracture from your trauma.  Generally speaking, if trauma has caused the bones to be shifted, they may need to be rebroken and reset.  It is best to consult with a board certified specialist who can assist you with achieving the results you seek. 3D computer imaging can also help you see what the results may be afterwards.

Different surgeons have different approaches for the same problem.  Ultimately  it is the final result that counts.  Find a board certified PS you are comfortable with and go with his judgement.Dr Corbin