Conditions

At MouradMD, we specialize in treating broken noses and nasal fractures. Our expert surgeons address issues such as cartilage damage, nasal septum displacement, and facial injuries. Whether caused by an accident, fall, or sports injury, we provide effective treatment options, including nasal splints and reconstructive surgery, to restore normal breathing and facial aesthetics. Contact us today for personalized care and solutions.

What is a Broken Nose?

A broken nose, or nasal fracture, involves a break or crack in the nasal bones and/or cartilage. This injury can affect the nasal septum, the wall that divides the nasal passages, and lead to various complications like breathing difficulty, infection, and saddle nose deformity. Broken noses are common in accidents, sports injuries, and falls, requiring immediate care to prevent further damage.

The nose is made up of:

• Nasal Bones: There are two bones at the top of the nose. These bones come together to form a pyramid shape at the top 1/3rd of the nose.
• Cartilage: There are 5 cartilages that form the middle and lower thirds of the nose. These are known as the upper lateral cartilages, found in the middle third, and the lower lateral cartilages (tip cartilages) that form the tip of the nose.

Any time there is damage to any of these structures, it may be referred to as a broken nose.

 Common Causes

1. Accidents: Vehicle collisions, workplace mishaps, and household incidents can cause nasal fractures.
2. Sports Injuries: Contact sports like football and boxing often result in broken noses.
3. Falls: Slips and falls, particularly in children and the elderly, can lead to nose injuries.
4. Physical Altercations: Fights or assaults can result in nasal bone fractures and other facial injuries.

Many broken noses go undiagnosed. If you have experienced trauma to your nose at any point in your life where there was a direct impact to your nose, there is a possibility that you may have broken your nose. It is crucial to disclose all nasal trauma history to your surgeon.

Signs and Symptoms

Depending on the location of the broken nose, you may notice different signs. The most common symptom would be a noticeable deformity involving the nasal bones and/or cartilages. Some nasal deformities which may be caused by a broken nose include:

• Open Roof Deformity: This refers to “splaying” of the nasal bones. The bones that form the top third of the nose should form a pyramid structure, coming together in the middle of the nose. If you break your nose in a way that makes the bones no longer come together properly, you form ridges on the top of the nose. These ridges are the edges of the nasal bones that no longer come together properly.
• Deviated Nose (Bridge): Sometimes the axis of the nose may be deviated, skewing to one side. This can refer to a fracture in the nasal bones, or nasal cartilages.
• Deviated Nose (Septum): If the nasal fracture involves the nasal septum, you may notice a nasal septum deviation in the middle portion of the nose. Deviated septum symptoms are typically mild but can include nasal obstructions, nosebleeds, and noisy breathing during sleep.
• Saddle Nose: This type of fracture refers to a break in the septum. This will result in a sagging or collapse of the middle portion of the nose, referred to as a saddling.

A broken nose typically presents with pain, swelling, and bruising around the nose and eyes. Common symptoms include:

• Nasal Pain: Intense pain around the nasal bones and cartilage.
• Swelling and Bruising: Swelling in the nasal area and bruising under the eyes.
• Breathing Difficulty: Obstruction of the nasal passages leading to difficulty breathing.
• Nosebleeds: Persistent nosebleeds or blood clot formation.
• Runny Nose: Watery fluid discharge from the nose.
• Nasal Septum Issues: Displacement or damage to the nasal septum.

How to Tell if Your Nose is Broken?

Determining if you have a broken nose involves checking for signs like pain, swelling, and deformity. Physical symptoms include:

• Visible Deformity: A misshapen or crooked nose.
• Severe Pain: Pain that intensifies with touch or movement.
• Swelling and Bruising: Significant swelling and bruising around the nasal area.
• Difficulty Breathing: Obstructed nasal passages.
• Nosebleeds: Continuous or frequent nosebleeds.
• Discharge: Watery fluid or blood from the nose.

When to Seek Medical Attention

Seek medical care if you experience severe, persistent pain that doesn’t respond to over-the-counter pain medicines, difficulty breathing through your nose, or a visible deformity like a crooked nose. Continuous nosebleeds, clear fluid discharge, and facial injuries such as vision problems or neck pain also require immediate attention. For children, prompt evaluation is crucial to avoid long-term complications. At MouradMD, our experts provide comprehensive care for nasal fractures to ensure optimal recovery.

Book a consultation with Dr. Mourad to assess your nose injury

How is a Broken Nose Treated?

Broken noses are typically corrected through surgery. The type of surgery depends on the timing of the nasal fracture and its complexity. There are two primary types of broken nose surgeries:

• Closed Reduction: his type of surgery is performed up to 7 days following the nasal fracture. Prior to the 8th day, the bones still have not fused, and can be manipulated and pushed back into place using external pressure. This can be performed in the office and under local anesthesia. This type of surgery only works with simple fractures that involve the bones. It does not address alterations to the nasal airway such as a deviated/fractured septum.
• Open Reduction/Internal Fixation: This type of surgery is performed beyond the 8 day mark after the injury has been sustained. After 8 days, the bones have already begun to heal, and in order to correct the deformity, the nasal bones need to be rebroken in a procedure known as an osteotomy. By breaking the nose in a controlled fashion, the nasal structure can be restored to its natural position.

In conjunction with open reduction, additional surgeries may be necessary to address complications from nasal trauma:

• Septoplasty: This surgery corrects a deviated nasal septum, improving nasal airflow and breathing.
• Nasal Valve Surgery: Damage or weakening of the nasal valves due to trauma can be corrected to restore proper nasal function.

Complementary Procedures

• Nasal Packing and Splints: These are used post-surgery to stabilize the nasal structures and support healing.
• Reconstructive Surgery: For severe fractures or saddle nose deformity, reconstructive surgery ensures both functional and aesthetic restoration.

At MouradMD, our expert surgeons provide personalized care and effective treatment options to ensure optimal recovery from nasal injuries.

See Before and After Patient Photos on Instagram

What is the Recovery and Follow-Up Like for Broken Nose Surgery?

Recovery and follow-up care for broken nose surgery at MouradMD are crucial for optimal healing. Post-surgery care includes managing swelling and pain, using nasal splints, and avoiding strenuous activities. Here’s a brief overview:

• Pain Management: Use prescribed pain medicines.
• Nasal Splints: Stabilize nasal passages.
• Activity Restrictions: Avoid strenuous activities and nose blowing.
• Follow-Up Appointments: Monitor healing and address complications.
• Additional Surgery: May be needed for severe fractures or deformities.
• Children’s Care: Ensure proper nasal development and function.

What Are The Risks If A Broken Nose Is Left Untreated?

If you break your nose, it is important that you have a full and thorough evaluation by a specialist. Because of the trauma associated with breaking your nose, it is not uncommon that other injuries occur at the same time, such as head/brain injuries or fractures involving the facial bones (jaw, cheeks, orbit, or skull) or eye. Other complications which may occur as a consequence of a broken nose include:

• Septal Hematoma: This refers to a collection of blood inside the nasal septum that leads to a septal perforation.
• Deviated Septum: This refers to a movement or shifting of the nasal septum.

Is Broken Nose Surgery Covered By Health Insurance?

Since breaking your nose constitutes a significant compromise to your health, it is typically covered by insurance. This becomes particularly important if the broken nose has caused a detriment to your ability to breathe that has impacted your quality of life.

Revision Rhinoplasty: The Pollybeak Deformity

What is a Pollybeak Deformity?

Pollybeak deformity refers to excess tissue over the supratip area (region over the bridge of the nose right before the nasal tip). This causes the nose to be beak-shaped in appearance, hence the name used for this deformity. This usually occurs from prior rhinoplasty surgery.

What causes a Pollybeak Deformity?

There are many causes of pollybeak deformity, each relating to what was done during the original nasal surgery. 

Aggressive Dorsal Hump Removal: Pollybeak deformities can occur when large bumps (referred to as “dorsal humps”) are aggressively taken down without accounting for skin re-draping. If you had a big bump on your nose that was removed, the skin over top of it will remain stretched out. This skin then sits on the bridge of the nose and bunches up in the area above the tip. Patients subsequently develop excess scar tissue underneath the skin, causing the characteristic bird-like appearance. 

Inadequate Dorsal Hump Removal: Pollybeak deformities can also result from inadequate removal of the nasal bridge. If the prior surgeon failed to remove a dorsal hump in its entirety,

you may be left with excess tissue in the supratip area that also causes a bird-like appearance of the nose. 

Poor Management of the Tension Tip: Sometimes a person may undergo a primary rhinoplasty for a “tension tip.” This refers to a strong, prominent nasal tip. This often may be associated with a dorsal hump. Sometimes the original surgeon may remove the dorsal hump without addressing the strong nasal tip cartilages. This results in the tip of the nose protruding outwards along with the supratip area, causing a pollybeak deformity. 

What are the symptoms of a Pollybeak Deformity?

How do you correct a Pollybeak Deformity?

Surgery is usually the preferred method of correcting a pollybeak deformity through a revision rhinoplasty approach. Depending on the cause of the deformity, the surgeon must correct any inadequacies from the original surgery. In many cases, grafting material such as rib grafts (link to rib) may need to be used in order to correct the deformity. 

Does Dr. Mourad Perform Corrective Surgery for Pollybeak Deformities?

Yes, Dr. Moustafa Mourad is highly skilled in performing corrective surgery for pollybeak deformities. As a double board-certified facial plastic surgeon, Dr. Mourad specializes in revision rhinoplasty, a complex procedure aimed at correcting nasal issues that arise from previous surgeries. Pollybeak deformity is a common complication that can occur when too much cartilage or bone is removed from the bridge of the nose, or when the tip lacks adequate support, leading to a drooping appearance.

Dr. Mourad’s expertise in this area allows him to precisely address both the cosmetic and functional aspects of the deformity. During a corrective procedure, he carefully reshapes the nasal structure to restore balance, improve the nasal contour, and provide better support to the nasal tip. In doing so, he not only enhances the aesthetic appearance of the nose but also improves airflow, alleviating any breathing difficulties caused by the deformity.

Patients can expect a thorough evaluation prior to surgery, where Dr. Mourad takes the time to understand their concerns, examine the nasal structure, and explain the tailored surgical plan. Below, you can view photographs of patients who have undergone successful corrective surgery for pollybeak deformities, showcasing Dr. Mourad’s ability to deliver natural and satisfying results.

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What is a Saddle Nose Deformity?

Saddle nose deformity refers to a collapsed nasal bridge, or loss of nasal height. The “saddle” in the name of this condition is used to describe the appearance of a sagging middle portion (also known as the mid vault region) of the nose.

Figure-1: Before and after photos of a Saddle Nose Deformity. The patient sustained trauma to the nasal bridge that caused a fracture of his septum. In the before photo, please note the part of the bridge which has collapsed above the tip of the nose. This is caused by collapse of the nasal septum, a key structural component of the nose.

What causes a Saddle Nose Deformity?

There are many things that can cause loss of nasal height. The nasal septum is key to the structural integrity of the nose. It is essentially the central pillar of the nose, providing a majority of its structural stability. Any condition that compromises the nasal septum can lead to a collapse of the nose. Regardless of the cause, the end result will often be the nose taking on a sunken appearance. 

Prior Surgery.  Prior septoplasty or septorhinoplasty surgery may lead to a saddling of the nose. If an aggressive septoplasty is performed which removes the majority of the septum, this can lead to weakening, and even collapse, of the nose over time. Additionally, any septoplasty procedures performed in patients that are too young can result in a saddling of the nose later on as individuals grow.

Trauma. Trauma is the number one cause of nasal saddling. Any trauma to the nose can lead to saddling or sagging of the nose. If the septum is fractured during trauma, it becomes weakened, resulting in loss of nasal height. 

Septal Hematoma and Septal Abscess. Collection of blood or pus in the septum – either from trauma, surgery, or manipulation of the septum – may compromise blood flow to the septum, causing nasal saddling.

Autoimmune and Vascular Disorders. Autoimmune and vascular disorders may lead to vasculitis (or inflammation of blood vessels) in the septum. This inflammation leads to decreased blood flow to the septum, which can result in tissue necrosis and loss. Disease progression leads to weakening of the septum and loss of nasal height. Example disorders include Wegener’s Granulomatosis and Relapsing Polychondritis. 

Cocaine Use. Chronic or long-standing cocaine use will also decrease blood flow to the nasal septum, causing tissue necrosis and loss. This ultimately leads to shrinking of the nasal septum and loss of nasal height.

Infections. Chronic infections such as syphilis may also compromise blood flow to the nose and septum, leading to nasal saddling.

What are the symptoms of a Saddle Nose Deformity?

The number one symptom is an external deformity of the nose with a characteristic sunken appearance. However, because of where the deformity is located and the likelihood that it was contributed to by poor healing, you may also experience difficulty breathing through one or both of your nostrils. Additional symptoms may include nasal septal perforation, chronic crusting, nose bleeds, and nasal discomfort.

How do you correct a Saddle Nose Deformity?

Surgery is usually the preferred method of correcting a saddle nose deformity through an open rhinoplasty approach. If the issue is caused by an overly aggressive previous rhinoplasty or septoplasty, then secondary rhinoplasty surgery may be necessary. Often, grafting material such as rib grafts may need to be used in order to correct the deformity. 

Does Dr. Mourad Perform Corrective Surgery for Nasal Saddle Deformities?

Yes. Dr. Mourad is an expert in the surgical repair of saddle nose deformities. He has a high-volume practice who specializes in rhinoplasty surgery to correct saddle nose as well as other complex deformities of the nose. He is a double board certified facial plastic surgeon with expertise in revision rhinoplasty surgery. Below are example photographs of patients that have undergone corrective surgery of saddle nose deformities.

Figure-2: Before and after photo of patient with nasal saddling from trauma. Note the restored contour and height of the nasal bridge.

Figure-3: Before and after photo of patient with nasal saddling. The patient had two prior septoplasty surgeries with overly aggressive removal of the septum which resulted in nasal saddling.