What is a Broken Nose?
A broken nose refers to external malalignment of the nose, usually related to trauma. It is the most common facial fracture related to the external projection of the nose. A person may experience a fracture in any of the different parts of the nose. The nose is made up of two bones and five cartilages. Most often, the nasal bones are involved in a nasal fracture. This usually presents as a deviation of the top 1/3d of the nose, where the nose appears misaligned. Cartilage fractures are involved in the lower 2/3rds of the nose, and may be less obvious and more difficult to diagnose.
How do you treat a broken nose?
There are different treatments of a broken nose, and will vary based on the history and presentation of your specific fracture.
Closed Reduction– Closed reduction refers to manual reduction of the nasal fracture either in an office or an operating room. By using external and internal pressure to the nasal bones, the bones can be re-aligned to their natural position. This is usually done in the acute time period (less than 7 days from the time of the trauma). If more than 7 days have elapsed from the time of fracture, then you may not be a candidate for closed reduction. By 8 days, the bones have already begun to fuse, and manual manipulation of the bones is difficult, requiring an open reduction. Closed reduction is also reserved for simple fractures of the nose. Complex fractures, such as fractures with severe compromise to the nasal structure of the nose, often will require an open approach.
Open Reduction- This is often a misnomer, as not all open reductions require “open” access to the nose. Open reduction of the nasal fracture will refer to the process of “re-breaking” the nose. This happens when the time from fracture is beyond 7 days. In this scenario, controlled breaks, referred to osteotomies, are made in specific parts of the nose in order to break the nose into its normal/natural position. In the case of severe fractures, this may require an open rhinoplasty approach, in order to reconstruct severely compromised portions of the nose.
Why Is a Broken Nose Important?
Compromise to the integrity of the nasal structure may lead to long term problems associated with nasal health. For example, an untreated nasal fracture, particularly at a young age may lead to long term problems with breathing and overall aesthetics of the nose.
Preparation For A Broken Nose Surgery
You will meet with Dr. Mourad where he usually spends an hour going over everything related to your surgery. He will evaluate and make sure that he can specifically tailor a custom care plan to your exact needs. During the consultation, Dr. Mourad will determine the exact nature of your complaints and the exact causes. He may prescribe medications that will assist in your complaints. Once a tailored plan is made, Dr. Mourad and his staff will take you through all the necessary information needed to make sure that your surgery happens without issue. We take care of the details so that you can have the most enjoyable experience.
Dr. Mourad views treating his patients to be nothing short of a privilege and an honor and enjoys taking the time to get to know his patients and fully understand their issues. Dr. Mourad’s office provides a boutique experience that takes you out of the mindset of being at the doctor’s office. It is a warm, comfortable environment, providing a bespoke experience.
How Is The Recovery From A Nasal Fracture Reduction?
The recovery is not fun at all although it is generally not very painful. Most patients do have obstruction of both sides of the nose that lasts for most of the week or even until you see your doctor. Dr. Mourad provides pain medication if you need it but most of the time Tylenol or no medication is used. You return to our office one week after your procedure and your nose is decongested with any crusts removed from inside of the nose. Most patients are breathing better within a couple of weeks as the swelling inside of the nose improves.
Associated Risks
- Anesthesia: Depending on the type of anesthesia administered, patients may have a reaction. This is exceedingly rare, and it is important to discuss your personal risk with your anesthesiologist.
- Infection: In rare circumstances patients may develop an infection following septoplasty procedures. These are usually managed with intraoperative and postoperative antibiotics.
- Bleeding: Although rare, patients may have bleeding episodes following nasal surgery. Your surgeon will likely order blood work to make sure you are healthy enough to undergo the procedure. Your surgeon should also go over all medications and supplements that you take to minimizing bleeding risk.
- Need for secondary and revision surgeries: Depending on the complexity of the surgery, sometimes multiple surgeries are required to ensure the best aesthetic and functional outcomes.
- Scarring and Poor wound healing: Some patients with underlying medical conditions or more prone to poor wound healing and scarring. It is important to understand these risks prior to embarking on a treatment strategy.
- Local Reactions: Sometimes you may experience local reactions to the ointments, sutures, taping material, and nasal packing used during surgery and postoperatively. This is rarely seen, but may occur. If you have any allergies to certain materials or adhesives you should discuss with your surgeon.
- Changes in nasal sensation: Patients may experience altered sensations in their nose (pain or numbness). This is exceedingly rare, and if it occurs it is most often temporary.
- Persistent or Recurrent Nasal Airway Obstruction: Although the goal of surgery is to enhance breathing, sometimes patients may develop persistent or recurrent airway problems. This is rare, but oftentimes is due to poor wound healing or scarring (see above). This may require secondary surgeries to optimize outcomes.
- Continued need for medical therapies: If you have breathing complaints related to medical causes (e.g. allergies), then you may continue to require medical nasal therapies (e.g. nasal steroids and sprays).
- Nasal Septal Perforation: A hole in the septum may develop. Oftentimes these do not cause any problems. Other times however, they may cause crusting, bleeding, and breathing difficulties. These require secondary surgeries for repair.
Can I Have Other Procedures With My Broken Nose Surgery?
Yes. You can have a turbinate reduction or valve repair to further improve breathing, in addition to a septoplasty. You can also have sinus surgery or removal of polyps to improve sinus function. If you have a bump or other areas of your face that you would like addressed then you can have cosmetic surgery at the same time.
Does Insurance Pay For Broken Nose Surgery?
Most insurances will pay for functional surgery of the nose, that is, surgery that improves the ability of your nose to work well. Our office will check your benefits for you and let you know what your responsibility will be. We don’t believe in patient surprises and will keep you informed throughout the process. You may have co-pays, deductibles, and co-insurance which we will tell you about. We try to keep our services affordable as we all have financial responsibilities. Of course, cosmetic surgery is never covered by insurance.
