How Do I Know If I Have Broken My Nose?
Broken noses are not always obvious on exam or even x-rays. Generally, if your nose looks different, more crooked or flattened, and is sore for several weeks, that is a good indication.
Other signs are new nasal obstruction or bleeding from the nose at the time of the trauma. (Angela Sturm, MD, Houston Facial Plastic Surgeon)
Nasal fracture
If you are grossly swollen and bruised, chances are the nose is broken. But don’t fear, it may not require surgery as the fractures may be undisplaced. At 7-10 days most of the swelling will have resolved and you can assess whether there is any deviation of the nose.
If there is then see a PS and he/she can perform a closed reduction to manipulate it back into its pre-injury position. The decision to proceed to surgery is a clinical one, ie twisted nose, not a radiological one. (Pouria Moradi, MBBS, FRACS, Sydney Plastic Surgeon)
How to tell if your nose is broken
There is no easy way to know if your nose is broken. The nasal bones are the easiest bones to break on the face and X-rays can easily miss a hairline fracture.
Even if the bones are broken, if the nose looks straight there is no reason to do anything.
I recommend waiting for the swelling to come down after 5-7 days and look at your face in the mirror. You can then tell at that time if the bridge of your nose is crooked.
The bones should be straightened for one of two reasons, there is an obvious crooked nose or there is trouble with breathing in which case the septum (middle portion of the inside of your nose) may have fractured as well. (Kristina Tansavatdi, MD, Los Angeles Facial Plastic Surgeon)
Broken Nose Diagnosis and Treatment
If you go to an ER, they may do X-rays. In some cases, these will show a fracture in the nasal bones. However, X-rays are not really necessary and will miss some fractures – including fractures of the septal cartilage. The best way to assess for a broken nose is physical exam by a nose surgery specialist. If the nose bones are mobile or deviated, or if there is air under skin (making a crackling sound when touched), these are indicative of a fracture. Another important item is to examine the septum, to check for hematoma or fracture here, which would need to be taken care of. (Evan Ransom, MD, Bay Area Facial Plastic Surgeon)
Evaluating a nose for a possible fracture
Identifying a broken or fractured nose is not always straight forward.
- If there is obvious displacement then it is most likely fractured. You should definitely see a nose surgeon if this is the case because a simple closed reduction (manipulation to re straighten the nose) may then be necessary.
- An xray may or may not always pick up a broken nose because the nasal bones are small and sometimes it may just be cartilage that is fractured and this usually does not show up on routine x-rays.
- The most important thing to identify after nasal trauma is the presence of a septal hematoma. If this is missed and it is sizable, it could lead to a perforated septum which is often times more problematic to treat then a broken nose. (Michael A. Epstein, MD, Chicago Plastic Surgeon)
Nasal Fracture Diagnosis
Nasal fractures are very common. Many children fracture their noses and don’t even know it. As an adult if you sustain a nasal fracture you can expect significant swelling and bruising within a few hours of the injury. Whether or not your nose is fractured (broken) may not be that important. If it still looks good, and your breathing returns to normal, it doesn’t require any treatment. It is possible to fracture the cartilage which may not show up until months later when everything is healed. This can result in a crooked nose and may affect breathing. It is best to have your nose evaluated 7-10 days after injury, once the swelling is gone and then again in 6 months. (Steven L. Ringler, MD, FACS, Grand Rapids Plastic Surgeon)
How Do I Know if my Nose is Broken?
There are obvious signs and subtle signs of a fractured nose. If is twisted, deviated, mobile, or flattened then it is probably broken. If it is swollen, it may be broken and X-ray studies may help in the diagnosis. If there is an immediate nosebleed after trauma then it is probably broken (Thomas Guillot, MD, Baton Rouge Plastic Surgeon)
Form and function following rhinoplasty.
The 2 key issues following isolated nasal trauma are a) Is the nose deformed? and b) Is nasal obstruction present? A physical examination by a qualified nasal surgeon is recommended at 1 to 2 weks following trauma if either of these findings are present. (Mario J. Imola, DDS, MD, Denver Facial Plastic Surgeon)
Broken nose?
X-rays or a CT scan will tell you if the nasal bones are fractured,but this really does not help in making a surgical plan. My approach is to first evaluate the nose to make sure their is no blood clot under the inside tissues (septal hematoma) or marked deviation/displacement of the nose.
If either of those are present, the nose is broken and early intervention is indicated. If not, give things 4-6 weeks to settle down. Then if there is problems breathing or a noticeable to deformity that both you and the surgeon think would benefit from correction, then surgery is indicated.
If not, even if the nose had been broken, I would recommend against surgery. (Mark Hamilton, MD, Indianapolis Facial Plastic Surgeon)
The nasal bone can be fractured but usually it is only relevant if it looks different or does not function as well (i.e. congested breathing). Frequently if you go to an emergency room x-rays or Ct scans will be performed. If it is just an isolated nasal injury these studies may not be needed. The important assessments can generally be made on in person exam. Once any acute issues are dealt with after a traumatic injury, I would recommend waiting at least a week and reexamine the nose once swelling subsides.
At that point it is easier to tell if there are any new changes secondary to the injury that would benefit from repositioning the nasal bones. If it looks crooked and feels as if the nasal bone was fractured then it may be worth repositioning the bones; this should generally be done within two weeks after the fracture. (Robert Glasgold, MD, East Brunswick Facial Plastic Surgeon)
Just wait 2 weeks and see if you have a nasal deformity or if you are not able to breathe through the nose well. If any of these is present you may have a fracture that will bneed to be addressed.
Oh the other hand many fractures of the nose do not need to be addressed even if they show up on CT. (Vartan Mardirossian, MD, Jupiter Facial Plastic Surgeon)
Broken Noses Are Just Like Other Broken Bones
Sometimes, it’s obvious that you broke your nose, like when, after a scuffle, your nose is pointing off towards one ear and you have big bruises under your eyes. Sometimes, it’s more subtle than that. The nasal bones are actually very thin, about the thickness of a fingernail, so they’re pretty easy to break.
But, like your wrist or your leg bones, sometimes you can have a severe break and at other times it’s a hairline fracture. If your nose is a little sore and swollen but looks mostly like it did before the injury, you can wait for the swelling to go down to see if there is any cosmetic change, like a new bump or crookedness.
This usually takes about a week for enough swelling to go down for your doctor to make a good assessment. Well trained surgeons don’t need an x-ray to do this (which is generally useless), they can base their evaluation on a physical examination of your nose. The exception to waiting is if you have severe breathing obstruction after the injury – this needs to be evaluated urgently to rule out a septal hematoma.
It is possible for the cartilage to fracture in addition to the bone which can lead to a deviated septum or other reasons for breathing issues. If the swelling settles and there is minimal change in appearance or breathing, even if your nose was broken, it doesn’t necessarily have to be fixed surgically – it will heal on its own.
f, on the other hand, you have a noticeable change in appearance or function, you should seek out an experienced facial plastic surgeon to discuss your options as getting a twisted or crooked nose as straight as possible is sometimes not as easy as it sounds.
For more information, you can check out our webpage on the subject. (Jason Litner, MD, Beverly Hills Facial Plastic Surgeon)
I got in a little scuffle and my nose is hurt and swollen. How Do I Know if my Nose is Broken?
In general when the nose is swollen, it hurts, there is bruising and specially having nose bleed immediately after an injury requires further examination by a plastic surgeon or at least an emergency room physician to decide whether an x-ray or a CT indicated. (Bahman Guyuron, MD, Cleveland Plastic Surgeon)
A Broken Nose does not need to be repaired right away…
A suspected broken nose should be evaluated because rarely a hematoma in the septum can occur. If this is not remedied, the cartilage of the septum can collapse causing deformity.
If septum is OK, then the question is not necessarily “Is it broken?” but “Do I need to do anything about it?” A nose may be broken and have only a small crack that heals well by itself. The only way to know is by X-ray.
Typically, when the nose is fractured, it swells, and it can take a month for the swelling to go down. At that point it can be evaluated for both deformity and breathing obstruction to see if intervention is needed. If it is straight and breathing is fine then no surgery is required. (Andrew Miller, MD, Edison Facial Plastic Surgeon)
The signs of a broken nose can vary from sudden inability to breath through your nose, to nasal swelling, to outright cosmetic deformity of the nose after trauma.
It is often difficult to tell if the nose is broken clinically until the swelling has gone down, which takes a few days, and then it is a judgement call as to whether or not anything actually needs to be surgically corrected.
If you have a concern, seek consultation with a board certified plastic surgeon to make sure that you get excellent care for your nose. (Jeremy B. White, MD, Aventura Plastic Surgeon)
It is common to have swelling of your nose anytime after nasal trauma. If you are having difficulty breathing, persistent bleeding from your nose, or you notice an obvious contour deformity, you may have fractured your nasal bones, septum, or both.
If you feel fine and look no different, it is unlikely that you have had a clinically significant nasal fracture. (Lara Devgan, MD, MPH, New York Plastic Surgeon)
Swelling doesn’t mean that your nose is broken, nor does bleeding or pain. Wait until the swelling goes down and if you have any difficulty with breathing, a change in appearance or lasting pain, it may be broken although an exam is the only way to know for sure. (Jerome Edelstein, MD, Toronto Plastic Surgeon)
Wondering if nose is broken?
I can completely understand your preoccupation! The biggest concern in the short term is if you develop bleeding inside the nose along your septum, which can be very problematic – and it is worth a trip to the ER or a plastic surgeon to be evaluated for this.
If all of this is ok, then the primary concern if a nose is broken is if you develop breathing problems, and/or your nose looks significantly different and is bothersome to you.
If you don’t have either of those issues, then you need not worry and with time the swelling and pain will resolve. If you notice that after the swelling resolves you are having more difficulty breathing or that your nose appears different, I definitely advise being evaluated for correction. (Bryan Correa, MD, Houston Plastic Surgeon)
Broken Nose?
If your nose looks distinctly different such as being crooked or having a new bump that was not there previously, or, you have difficulty breathing that you did not have before, you should have your nose checked out by a rhinoplasty surgeon. X-rays are sometimes helpful but not always necessary. (P. Craig Hobar, MD, Dallas Plastic Surgeon)
How Do I Know if my Nose is Broken?
Signs of a fracture include difficulty breathing out of one or both sides and bleeding at the time of the injury, bleeding at the time of injury, swelling, or an obvious deformity (e.g. deviation to one side). If you think your nose is broken, I would make an appointment with an otolaryngologist, facial plastic surgeon, or plastic surgeon to determine exactly what’s going on. (Parker A. Velargo, MD, New Orleans Facial Plastic Surgeon)
How do I know if my nose is broken? Is my nose broken?
It is difficult for a patient to tell if they have a broken nose unless there is a significantly asymmetric deformity. Most of the time you really do NOT need an xray to determine this. A physical exam is sufficient for most cases. I’m not sure if any insurances require a xray for repair. The most important reason to get an exam right away is to make sure you don’t have a blood collection inside the nose. This is what leads to the boxer deformity or saddle nose deformity. (Ben Talei, MD, Beverly Hills Facial Plastic Surgeon)
Nasal fracture
The nasal bones may be fractured and a significant nose bleed may occur without any visible change in shape of the nose. Injuries of this nature generally do not require any intervention.In more significant injuries the initial swelling may obscure any underlying deformity of the nasal bones. The true extent of the injury will become more apparent as the swelling subsides over one to two weeks following the trauma.
The nasal septum may be shifted toward one side and the airway may be partially blocked on that side. Surgical intervention may be necessary to reduce the fracture(s) and restore the airway. In the more severe injuries it will be obvious that the nose is shifted to one side and the airway is likely to be impaired on one or both sides. Surgical intervention is typically necessary. (J. David Holcomb, MD, Sarasota Facial Plastic Surgeon)