Broken noses

Did You Break your Nose? Our noses are one of the most prominent aspects of our faces, and for some of us one of the most protuberant. As such, when our faces hit other things around us, the nose frequently gets the brunt of the assault and does what it is designed to do, which is to break as it absorbs the shock aimed at our face.

Anatomy of the nose

The nose is made up of two main parts: the bony nasal pyramid in the upper third, and the cartilagenous portion in the lower two thirds and middle.

When things break, it is the hard parts that break: the bone and the central cartilage or septum. The nose will appear flattened or deviated. The septum may break to curve the nose and may even block the airway.

First aid for your broken nose

There is usually some bleeding that occurs after a nasal fracture; at times it can be severe. Controlling the bleeding is paramount.

1. Pinch your nose and hold it for five minutes. If it’s still bleeding, hold for another five minutes. If it’s still bleeding then, go to the nearest emergency room.

2. Place ice on your nose. This will decrease the amount of bleeding and also help with the resultant bruising that will occur.

3. Don’t blow your nose too hard, as you may restart the bleeding.

4. Sleep with your head elevated for 48 hours to minimize swelling.

5. Plan to see a cosmetic plastic surgeon as soon as you can.

6. That means call today. You may need a surgery within a week, and the sooner you start the process, the better.

Surgery for your broken nose

After your nasal fracture, you have about a 7-10 day window in which you can have a nasal fracture corrected surgically. After that, the tissues become too swollen and the healing process that starts naturally (to heal your nose from a crocked position) will not allow for any surgery for up to six weeks. Your tissues will simply not hold sutures and bones will melt away if you try to have surgery. The results will be disastrous.

 The surgery itself is usually not particularly painful or time-consuming. The nasal bones are straightened by directly pushing on them if it’s early on, and by re-breaking them if it’s later. The septum may also need to be straightened (a septoplasty) or may need removal of the fractured segments (a submucous resection, or SMR) if the airway is blocked and you cannot breath well from one nostril.

A cast is usually placed over the nose at the end of the surgery and will stay in place for about a week. There may be some bruising under the eyes and swelling of the eyelids to the point of making it hard to close them! Some bleeding from the nose may occur, but it should be minor.

Healing after rhinoplasty

The nasal cast is removed after one week, but the swelling will persist for months. It actually takes a whole year for all the swelling to dissipate and for your final nasal shape to become evident. Massaging the nasal skin will help this along, as will placing tape on the skin at night.

Your friends may tell you that your broken nose has added character to your face, but as your cosmetic plastic surgeon, I must advise you to find other ways to improve your character and to get your broken nose fixed pronto!