How do i tell if my nose is broken?
Nasal fractures are only impotant if they block your breathing or change appearance
It actually doesn’t matter if a X-ray shows a fracture: it only needs treatment if your nasal shape has changed or your breathing is now blocked. You would be wise to get examined so that someone can look inside and see that the internal nose is OK.
Then wait a few days and see how your appearance and breathing are. (Mark B. Constantian, MD, FACS, Nashua Plastic Surgeon)
When talking about a “broken” nose, its not the fracture of the bone that matters, its whether or not its displaced. Even if there is a fracture of the bone, if it is properly aligned it will heal with a normal appearance.
If you don’t feel a step-off in the shape of your nose, there is probably not much to be done. Your best action is to see a surgeon and be evaluated (Stephan Finical, MD, San Diego Facial Plastic Surgeon)
In order to determine if your nose is indeed broken, your physician will have to order an x-ray to visualize the position of your nasal bones.
Consultation and examination of the internal and external portion of the nose by an ENT/ facial plastic surgeon is also required to determine medical necessity, and to document the extent of the injury to the internal and external portion of the nose.
In many instances trauma to the nose creates a deviated nasal septum, which needs to be fixed at the same time as resetting the nasal bones. For many examples of broken nose repair please see the link below (William Portuese, MD, )
Common Sense Approach to Nasal Fracture
What we all like from our nose is something that looks great and functions properly. CAT scans and X-rays will tell you lots about the bone and soft tissue, but a broken nose that works great and looks great needs no treatment. In fact, if it looks and works great, treatment could be counter-productive.
If you think you broke your nose, have it examined immediately to rule out a hematoma. A hemotoma can cause a lot of damage to your nose if not drained early. For all but the most severe injuries, the next step is to wait one week for swelling and bruising to resolve.
Now you can evaluate it for appearance and function. If neither is a problem, great, leave it alone. Noses often times are fractured, but it is only a crack. These cracked noses don’t need surgery. If you have deficits in either function or appearance, you can choose to live with it, or have it fixed.
I would have it fixed!! You should proceed to surgery within 10 days of the injury to prevent it from “sticking” in the broken location. First approach to repairing a fractured nose usually is a closed reduction. Frequently this returns a nose to a pre-fractured state. If your nose fracture is severe, more extensive surgery may be necessary. After a closed reduction attempt wait for bruising and swelling to resolve and re-evaluate. If further work is necessary, then more advanced techniques are employed. (Louis W. Apostolakis, MD, Austin Facial Plastic Surgeon)
See a board certified plastic surgeon
If your nose has changed shape or been deformed, then it is possible that it is broken. You may have to wait until the swelling goes down to tell for sure. Otherwise, an X-ray may be necessary.
Also, if your nose bled significantly after being injured, that is a pretty good indicator for a broken nose. Make sure you see a plastic surgeon as soon as you can since his experience is invaluable in helping you diagnose a problem early on. (Sam Speron, MD, Chicago Plastic Surgeon)
A bump on the nose with swelling may well result in a fracture and the fracture may be very subtle and only appear on an x-ray. Most often nasal fractures go undiagnosed, individuals fall, get bumped, get hit, etc. The result is swelling, stuffiness and a little bruising, some tenderness, and not much esle to show for it.
When evaluated in the emergency room the x-ray will show the fracture and patients will then see us in the office to find out what must be done. If the nose shows any deformity or displacement, or the airway is shifed or compromised the decision is easy. Reduction and straightening are in order. If nothing shows we wait until the swelling is down in a week and look again. Again if we see a deviation or twist, or an airway issue unappreciated the week before we are off to reduce and straighten. However, if all looks well the nose should heal well wihout our help. To be on the safe side be careful of pressure on your nose and do not blow forcibly for two weeks, and stay out of the fray. (Peter E. Johnson, MD, San Diego Facial Plastic Surgeon)
Broken nose diagnosis
The best way to know if the a nose is broken is to see a nasal surgeon. But short of this, if the nose has changed shape or if it feels unstable when you move it, it is most likely broken.
At this point, you should get to a surgeon within a week so they can plan a closed reduction procedure, which will help to reset the bones. This is your best chance of avoiding a formal rhinoplasty down the road. (Amir M. Karam, MD, Charlotte Plastic Surgeon)
Advise for nasal trauma
The three things to consider with a possible broken nose are:
- Is there a change to the shape of your nose? If there is obvious deformity (other than swelling), there has probably been a nasal fracture and you’ll need to see a facial cosmetic surgeon. Many times this will not become evident until the swelling (edema) has abated. If you ice the nose 20 minutes each hour, usually you will be able to tell in 5 days.
- Is breathing through your nose negatively affected? Again, this may be secondary to swelling, but could also be because of structural changes. If this persists, it should be addressed by seeing a facial cosmetic surgeon.
- Do I have other injuries that need to be treated? If you have severe congestion, it may be a sign of septal hematoma (which is different than a nasal fracture) and this needs to be treated on an urgent/emergent basis to avoid the possibility of saddle nose deformity.
Severe nasal fracture may also be associated with other injuries to the adjacent structures (orbit, maxilla, etc). My recommendation: if you have severe congestion after the initial injury, at least be evaluated by a health care provider.
They will be able to determine if there is anything that needs to be treated urgently. If not, then icing the nose for 5 days will allow for the swelling to abate in order for you to make a better determination about #1 and #2 above.
Seeing a facial cosmetic surgeon before 5 days has passed is usually not helpful because the swelling needs to go down before the nose can be optimally straightened. If there is concern about breathing or cosmesis after 5 days, see a facial cosmetic surgeon to determine if treatment is required. There is approximately a 14-day window to manipulate the nasal bones without having to “re-break” them. (Sirius K. Yoo, MD, New York Plastic Surgeon)Go to an expert on rhinoplasty.
Correcting a broken nose can be simple in the first few days, if it looks lopsided or different than it was before , it may be broken. See a nose specialist. You may need an Xray = but the exam by the expert should give you a good idea. (William B. Rosenblatt, MD, Seattle Facial Plastic Surgeon)