Double Board Certified · Facial Trauma

Broken Nose — evaluate early; the timing changes the options.

Nasal fractures are the most common facial fracture. Most are reducible if evaluated in time; understanding the fracture pattern and the internal anatomy in the first two weeks gives the best chance of a definitive single operation.

ABFPRS

Facial Plastic & Reconstructive Surgery

ABOto

Otolaryngology — Head & Neck Surgery

AAFPRS

Fellowship Director

Editorial pencil-sketch portrait — post-traumatic nasal fracture

In Consultation

"The most common question after a nasal injury is whether to wait. The honest answer is to be evaluated quickly — then to decide carefully."

A Note from Dr. Mourad

"Nasal fractures are the most common facial fracture. Most are reducible if evaluated in time; understanding the fracture pattern and the internal anatomy in the first two weeks gives the best chance of a definitive single operation."

— Dr. Moustafa Mourad, MD

Overview

What is a broken nose (nasal fracture)?

A broken nose is a fracture of one or more of the bones or cartilages that form the nasal pyramid — typically the paired nasal bones, the frontal process of the maxilla, and/or the cartilaginous septum. It is the most common facial fracture and usually follows a direct blow during sport, a fall, an assault, or a motor-vehicle collision.

Acutely, a fractured nose may cause visible deformity, swelling, bruising, nasal obstruction, and bleeding. Some fractures also injure the septum and create a septal hematoma — a blood collection between the cartilage and its lining that requires urgent drainage to avoid permanent cartilage loss.

Most nasal fractures can be evaluated by examination; imaging is reserved for cases with suspected additional facial injuries. Treatment depends on whether the bones have shifted, whether there is functional obstruction, and how soon after the injury the patient is seen.

An Established Academic Authority

Double board certification. Fellowship director. Published author. A surgeon's surgeon.

ABFPRS

Board Certified

American Board of Facial Plastic & Reconstructive Surgery

ABOto

Board Certified

American Board of Otolaryngology — Head & Neck Surgery

AAFPRS

Fellowship Director

American Academy of Facial Plastic and Reconstructive Surgery

Textbook

Published Author

Contributions to the academic literature of facial plastic surgery

Dual board certification in both Facial Plastic & Reconstructive Surgery and Otolaryngology — Head & Neck Surgery.

Castle Connolly Top Doctor — Plastic Surgery, 2026

02 · Symptoms

How this condition typically presents.

Three patterns are most common. Patients often recognise themselves in one or more of these.

I

Visible Deformity

A clear change in the shape of the nose after injury — a deviation, a depression, or a widening of the bridge.

II

Persistent Obstruction

One- or two-sided difficulty breathing after the injury that does not resolve as swelling subsides.

III

Bruising & Pain

Periorbital bruising, tenderness over the nasal bones, and crepitus on gentle examination.

03 · Diagnosis

How the diagnosis is made.

Diagnosis begins with a careful history — when symptoms started, what makes them better or worse, and what has been tried.

Examination includes anterior rhinoscopy and, where appropriate, nasal endoscopy with a small flexible scope to visualise the deeper nasal cavity and sinus outflow tracts.

Imaging — typically a focused sinus CT — is obtained when the examination and history warrant it, and is reviewed in detail at the visit.

04 · Treatment Options

Treatments matched to the diagnosis.

Treatment is individual. The right answer ranges from continued medical therapy to a focused minimally-invasive procedure to definitive structural surgery.

01 · Why Dr. Mourad

Diagnosis first, treatment second.

Dr. Moustafa Mourad is double board-certified in Facial Plastic & Reconstructive Surgery and in Otolaryngology — a combination uniquely suited to evaluating both the structural and the medical components of nasal and sinus disease.

Every evaluation begins with a careful history, examination, and — where indicated — endoscopy and imaging. The diagnosis is made before any treatment plan is discussed.

Medical therapy is exhausted before surgery is recommended. When surgery is the right answer, the operation is the one your anatomy and disease actually require.

When to Seek Care

When to seek care promptly.

Severe facial pain, high fever, or visual changes — these warrant urgent evaluation.

Significant facial swelling or redness around the eye — evaluate immediately.

New or worsening obstruction after a recent injury — evaluate within days.

Persistent symptoms beyond a few weeks despite over-the-counter measures — a careful evaluation is reasonable.

Get a clear diagnosis

An honest evaluation often clarifies more in 45 minutes than years of trial-and-error.

Outlook

What to expect.

When the diagnosis is correct and the right treatment is applied, the outlook is generally good. Many patients describe meaningful improvement in sleep, exercise tolerance, and day-to-day energy.

When symptoms persist despite treatment, the workup is re-opened. Persistent symptoms with no answer almost always mean the diagnosis is incomplete.

Living Well

Day-to-day measures that help.

Daily saline irrigation, control of indoor allergens, and good sleep hygiene meaningfully reduce day-to-day symptoms for most patients.

Medical therapy, when prescribed, works best when used consistently rather than as needed — this is one of the most common reasons treatment seems to fail.

Frequently Asked

Patient questions, honestly answered.

Common signs include new crookedness, persistent one‑sided nasal blockage, bruising, and a palpable step or instability along the bony bridge. Some patients notice crepitus or an audible crunch with gentle palpation. Early swelling can obscure deformity for 48–72 hours, so reassessment after initial edema subsides is important. A focused clinical exam, including intranasal inspection, determines whether further treatment or imaging is needed.

Urgent evaluation is required for expanding nasal pain, rapidly worsening obstruction, uncontrolled bleeding, visible open wounds, or suspected complex facial fractures. Any concern for a septal hematoma—visible bulging of the septum with increasing pain—constitutes an emergency because it can damage cartilage. The emergency department can stabilize acute bleeding and screen for other injuries, but a facial plastic surgeon should be involved promptly when the septum or nasal framework is compromised. Timely specialist input matters because some procedures have narrow windows for best effect.

A septal hematoma is trapped blood between the septal cartilage and its mucosal lining, often presenting as a tender, bulging mass inside one or both nostrils. Patients typically report worsening blockage and increasing pain despite rest. Because the hematoma can deprive cartilage of nutrition, prompt drainage by a clinician is required to lower the risk of infection, septal collapse, or subsequent saddle deformity. If you suspect a septal hematoma, seek evaluation immediately rather than waiting for spontaneous improvement.

Closed reduction is most effective in the early post‑injury period, commonly within about 1–14 days while the bones remain mobile and before firm callus formation. Exact timing depends on swelling, fracture pattern, and the patient’s clinical status; the exam determines candidacy. After this acute window, ongoing healing and scar maturation make manipulation less predictable and may require delayed reconstructive approaches. Definitive timing and anesthesia choices are set after an in‑person assessment.

Yes. Patients who present late can often improve breathing through staged reconstructive techniques such as septoplasty, nasal valve repair, or septorhinoplasty with grafting. Outcomes depend on the extent of prior cartilage loss, scar tissue, and the fracture pattern. Delayed repair typically waits for edema and soft‑tissue settling, commonly several months, to allow accurate surgical planning. Your surgeon will outline realistic functional goals during an office consultation.

Closed reduction can be performed under local anesthesia with sedation or brief general anesthesia depending on patient comfort and fracture complexity. The procedure itself is brief; perioperative discomfort is generally short‑lived and managed with oral analgesics. Patients should expect congestion and soreness for several days and receive instructions on packing, splints, and activity restrictions. An in‑person visit determines the safest anesthesia strategy for each patient.

Imaging is selective for isolated nasal fractures. Plain X‑rays rarely alter management for simple nasal bone breaks. CT imaging is reserved for suspected comminution, possible adjacent facial or orbital fractures, ambiguous exams, or planning for complex reconstructive surgery. Clinical examination remains the primary triage tool; your surgeon will order imaging only when the results will influence care.

Return to noncontact daily activities is often possible within 1–2 weeks after closed reduction, while avoidance of contact sports is generally recommended for at least six weeks. For full return to high‑impact contact sports the timeline may extend to 8–12 weeks depending on healing, fracture pattern, and the surgeon’s assessment. Protective equipment and individualized clearance from your surgeon are advised. These timelines are general; specific guidance will be provided at follow‑up visits.

Insurance commonly covers medically necessary care such as septal hematoma drainage, treatment of airway obstruction, and functional repair after trauma. Purely cosmetic procedures for appearance alone are typically not covered. Coverage varies by carrier and plan; providing ER records, imaging, and operative notes helps when filing claims. Your consultation will clarify which components of care are likely to be billed as medically necessary versus elective.

The Most Important Step

Get an expert evaluation.

A careful evaluation by a double board-certified physician is the right first step. The conversation is unhurried, the diagnosis is honest, and treatment is matched to what you actually have.