Rhinoplasty Forum and Chat

Support Forum, Chat, and Message Board for Patient's Questions and Answers Broken Nose (Nasal Fractures)

Explore what others have to say about a Broken Nose and Plastic Surgery with answers by Dr. Michael Bermant, MD.

Michael Bermant, MD
Board Certified by the American Board of Plastic Surgery

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This is the page where you can review questions and stories from patients, view the opinions of lay persons, and see answers from Dr. Bermant and other physicians. Do you want to ask a question, post an answer, or make a comment? Information E-mailed to me will be considered for posting.

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Information posted in this section does not necessarily reflect the opinion of Dr. Bermant.

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Rhinoplasty Nasal Surgery Important Information

Question: *Re: Nose surgery

To whom it may concern:

I saw your web-site and I think you may be able to help.

When I was 5 years old, I hit my face many times, and now, after 22 years, I notice my nose has a very strange shape. It is normal size in the nostrils area and almost flat in the area between the eyes and below it. I have seen that shape in some boxers' noses.

The questions are:
1) Can this be reconstructed? (Size increased)
2) And if so, how much would it cost?
3) I am an international student, if I increase my nose size, would I need to change my passport picture after the operation because my face has changed dramatically?

I would appreciate any help you may give me.

Thanks

Dr. Bermant responds:

This should not be construed as medical advice. I am a Board Certified Plastic Surgeon.

You need an evaluation by a surgeon who can give you a realistic appraisal of what can be done. Surgery cost is a function of what needs to be done. Flattened noses can sometimes have new support from tissue taken from other parts of the body (ribs, hip, septum). Cost can run from as low as $500 to $10,000 or more. A radical change in image is best handled by a new passport photograph.

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD



Question: Re: Broken Nose

My son fell on face after tripping over a ball. The impact appears to have been on his nose. His nose bled, and swelling occurred. We placed ice packs on the bruise to avoid additional swelling. Since he was in no pain, we took no further action. Twenty-four hours later, his nose appears to be better but still swollen. How do we know if it's broken? Should we pursue medical advice?
Thank you for your attention.

Dr. Bermant responds:

This should not be construed as medical advice. I am a Board Certified Plastic Surgeon.

The nose should be evaluated by a physician who can tell you if any intervention is necessary. I perform an examination to tell my patients what should be done. Nasal fractures that have bones, or cartilage out of place should be reduced before the structures start healing. The septum needs also to be checked for a septal hematoma which might need to be drained.

Take a look at my nasal fracture brochure at my website:

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD


Question: Re: broken nose

I was punched in the nose four days ago and it is still sore and puffed up on both sides of my nose. I have been sneezing constantly since the initial blow. It originally bled , but stopped after two days. When I try to push my nose to either side , I can feel some kind of separation around the middle of the nose. I have no black eyes and my question is how long should any one wait if he thinks the nose my be broken?

Thanks,

Dr. Bermant responds:

This should not be construed as medical advice. I am a Board Certified Plastic Surgeon.

Do not wait. Displaced nasal fractures are harder to treat as the bones and cartilage start healing in the new wrong position. By 10 days it starts getting hard to reset fractures. Septal hematoma can also be a major problem and are much better taken care of early. Check out my nasal fracture information on my website.

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD


Question: Re: nose injury

Dear Doc,
I had hit the bridge of my nose in the gym while working out had, xray was neg. but I'm getting a pressure sensation , .There is no outward swelling nor bruising , could I have caused sinus damage , If so which sinus could be damaged or injured, also could that lead to sinus disease .
Thank you ,

Dr. Bermant responds:

This should not be construed as medical advice. I am a Board Certified Plastic Surgeon.

Advice about correction of problems needs an evaluation. I cannot comment without an examination and evaluation. Generally fractures are swollen and tender early on. Some fractures are of deeper bones leaving the surface bones intact.

A sinus has a mucosal lining over bone. Small openings connect the sinuses to the nose. Trauma can injure the mucosa lining causing bleeding with minimal to no fracture (a severe bend in the nasal septum can leave no fracture or crack but split the covering mucosa). Injured mucosa can swell. Such swelling or deviation of other nasal structures can lead to obstruction of the small openings that drain the sinuses. Although trauma can lead to sinus obstruction, the common cold and allergies are more common causes of sinus obstruction.

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD


Re: nose injury

Thank you very much !!



Question: Re: Cost nasal recon

Dear Sire:

Problem- nose has been broken to the extent that the cartilage in the middle of the nose has been flattened. Can this condition be repaired and approximately how much would it cost. Exploring possibility of plastic surgery and would appreciate some information.
Thank you

Dr. Bermant responds:

This should not be construed as medical advice. I am a Board Certified Plastic Surgeon.

There are many reconstructive options for nasal deformity. You will need a rhinoplasty evaluation and examination before I can discuss the multiple possible surgeries commonly called rhinoplasty. Bone and cartilage can sometimes be moved or reshaped. Other times the defect is camouflaged with bone, cartilage, or other material. Cost of nasal reconstruction depends on what is done.

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD


Question: Re: nasal fx, 5-yr. old daughter

Dear Dr. Bermant:

Hello, my name is Susie. I have a daughter (5) who had a trauma to her nose in her school's cafeteria. She was running, slipped in water, and rammed herself nose first into the metal door jam. The x-rays confirmed my own suspicions, not to mention her doctor's. She saw the an E.N.T. for the second time today (after the swelling had gone down). We discussed the matter in detail, he took 2 photographs and simultaneously were in agreement; surgery for her was forthcoming.

She will be having this closed-reduction done while under anesthesia, of course, on Thursday. This will be her first (semi) hospitalization since birth, not to mention, her first time under anesthesia. I myself, am no stranger to any of it. In 1967, at the age of 7 1/2 mos. I had my first open-heart surgery. In 1976, my second open-heart surgery, In 1987 removal of a mole which had tested to be Malignant Melanoma. For precautions, the doctors also removed 26 Axillary lymph nodes; all of those tested negative. Thanks be to God, nothing so far has returned in that area or any other. In addition to those surgeries, I had 2 nasal reparations (correct suspected, previous broken nose as a child), remove lengthy cartilage from tip of nose---both at age 16 then 17). Then in 1989 and 1991 or 92, I had 2 sinus surgeries for acute sinusitis troubles. Now days, I suffer from Congestive Heart Failure and will just be turning 31 in August. I have a lot of compassion to teach my 2 kids, just from having "BEEN THERE, DONE THAT".

I just wanted to thank you for your indepth documentary on nasal fxs. It was very informative, descriptive and in it you explained the entir process so well!!!

Thank you very much,

Hope I didn't bore you too much,

S

Dr. Bermant responds:

hope surgery comes out well

Michael Bermant, MD


Question: Re: torn nose cartilage

Just recently I hit my nose and now I can feel a little piece of torn cartilage in the upper part of my nose. I didn't hardly swelled and it doesn't really hurt. Should I go to the doctor or will it heal.

Dr. Bermant answers:

This should not be construed as medical advice. I am a Board Certified Plastic Surgeon.

Nasal injuries can include internal tears and dislocations of the attachments between the nasal cartilages. There are many other types of injuries that can cause localized swelling of the nose.

Yes get to a knowledgeable doctor who handles nasal injuries. The earlier the better. That is the only way I know to find out if something needs to be done.

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD


Question: Re: Nose Problems

I am a 20 year old male from Australia. I was wondering if you could give me a bit of advise as to what can be done about my nose. About 10 years ago I ran up the back of someone and crunched my nose. I don't now if it was broken, it basically just brused. I didn't do anything about it as I was a little young, but from as far as I can remmember, it has always had a lump. It does not lean towards one side or elongated in any way and I have no problems in breathing or bleading noses, it just has a hard lump (which feels like bone) in the middle. Can anything be done to make it just a straight ordinary nose, what roughly would be the price, and where would the precedure be done at. I would appreciate it if you could give me an E-mail back if you have any suggestions on ...

Thankyou

Dr. Bermant responds:

This should not be construed as medical advice. I am a Board Certified Plastic Surgeon.

Nasal deformity after trauma is not uncommon. Some nasal fractures are not displaced but still heal with a lump (callous). Other deformities can occur even with no fracture. Many deformities can be improved with surgery of the nose (rhinoplasty). The type and extent of surgery is best determined by an evaluation and examination. Cost for rhinoplasty nasal surgery depend on what needs to be done. Other fees may include ones for the operating room and the anesthesiologist. Simple hump removal may not need the anesthesiologist and the operating cost may be minimal. It is too difficult to be more specific without an examination and evaluation.

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD


Question: Re: nasal injury

Hi Dr. Bermant,

I was surfing the net on Rhinoplasty, and noticed your great work. I am in Massachusetts, so it is a little bit of a distance for me to travel. But I do have some questions, I hope you can answer.

I was involved in a motor vehicle accident, three weeks ago. Basically my car, wrapped around a telephone pole. In the process, I was thrown into to windshield. Along with many other aches and pains, I have a slight skull fracture and a concussion. I have a lot of pain in the bridge in my nose To the touch of my nose, the pain shoots all the way into the back of my eyes. Two weeks after the accident, the doctor took an x-ray of my nose, and said it did not look broken. Well, I know I am in a lot of pain, it causes me great headaches in the back of my eyes, I'm having trouble breathing, and the shape of my nose is a lot different (for the worse) than it was before.

What should my next step be? Do I make an appt. with an ENT? Do I get an orthopedic to look at it? Can a plastic surgeon look at it and refer me to have surgery? Do insurance policies cover surgery like this, in my case? The accident was not at my fault. If possible, please e-mail me as soon as you get a moment. Thanks so much.

b>

Dr. Bermant responds:

This should not be construed as medical advice. I am a Board Certified Plastic Surgeon.

Massachusetts is not that far, we see patients from further away. It sounds like you need an evaluation with someone comfortable with facial fractures. Nasal fractures can be simple or more extensive involving bones behind the nose and orbit. A surgeon familiar with such problems can easily decide if the prior X-rays and the clinical exam warrant further tests (a CAT scan can help make the diagnosis but I rather see a patient first). Displaced fractures do better with early reduction. Waiting more than 7-10 days can sometimes make reduction very difficult. Nasal swelling and difficulty breathing the nose can occur with trauma without fractures. But the examination is very important.

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD


Question: Re: broken nose

Dear Dr. Bermant

please give me assesment of my broken nose. for how much it would cost to replace it one with 0a plastic nose.

Dr. Bermant responds:

This should not be construed as medical advice. I am a Board Certified Plastic Surgeon.

Although I am a plastic surgeon we generally try to realign a broken nose and not replace it with a "plastic nose". We sometimes use a "plastic" nose to help a cancer or severe trauma patient with a false nose (prosthesis). This plastic nose is very useful for those too sick for nasal reconstruction.

I may be a good doctor but I have not seen anyone who has been able to assess a nose over the Internet from an E-mail question. You would need a consultation and evaluation for such information.

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD


Question: Re: Nasal Injury

I recently hurt my nose,and I had a X-ray ,and a catscan, it didn't show any type of fracture,but it was very sore. When the swelling and the soreness past it healed with a lump that bows out a little(not hardly noticable), but the problem is it makes it difficult to waer eyeglasses, but it aggrevates it,I went to see My ENT doctor who said that he can do a surgical procedure where they go up through my nostril, and use a fine tunes instrument,to shave down the bone,I have scheduled the surgery,but am scared out of my mind,can you please tell me more about this procedure,and the recovery time

Dr. Bermant responds:

This should not be construed as medical advice. I am a Board Certified Plastic Surgeon.

Since I have not examined you nor am doing the operation, I have no idea. Your question is very reasonable for the doctor who is going to work on you. It depends on the extent of your problem, what your doctor is going to do, and your doctor's skills. My website is an example of my commitment to education of MY patients. If you are scared and still have questions, ask your doctor. I certainly would want my patients asking me such questions if they were still worried.

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD


Question: Re: reconstructive nose surgery

You can e-mail me at: .... Please put to the attention of K.Thank you. My question is, what is the least intrusive way to correct damage to a nose that has been damaged in sports activities? I have a nose that is literally off to one side with some obstruction on the damaged side. I keep thinking a surgeon would probably have to break the bone and reset it, and I would end up with a lot of packing in my nose too, yes? Is there anything less intrusive? Thanks so much! K.

Dr. Bermant responds:

This should not be construed as medical advice. I am a Board Certified Plastic Surgeon.

Nasal reconstruction after trauma needs an IN OFFICE CONSULTATION for evaluation and examination before commenting what can be done. Mechanical displacement of bones usually needs a mechanical repositioning of bones. We usually do not take a hammer and rebrake the nose. Reshaping of deformed noses is usually done with fine chisels, knives, and rasps. (The chisels sometimes need a delicate hammer to hit the chisel. The chisel then cuts the bone carefully.) We also use other materials to change contours and build up depressions. There are a large number of surgical options but all are unfortunately surgical. I have not yet came across the wand that reshapes the nose magically.

I usually avoid packing but it depends on the patient's problem and the correction necessary.

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD


Question: Re: broken nose

dear doc, I'm 18 years old and I broke my nose about 7 years ago. One of my naustrils is blocked but my major discomfort is the physical look I have to face (my nose is out of place from the top). I was wondering if a surgery could put back my nose straight back and if so what would be the approximate price. Would there be some permenent side effects after the surgery (swelled nose, easy bleeding, cicatrices...)??

Thanks for your advice

Dr. Bermant responds:

This should not be construed as medical advice. I am a Board Certified Plastic Surgeon.

Surgery to straighten a nose after trauma in past is called rhinoplasty. There are many different operations, all with the same name, that treat different problems.

Your questions are best answered by an examination and evaluation. I cannot do justice to your questions by a simple E-mail. Some basic answers appear on my website. There are many different types of rhinoplasty and prices depend on what needs to be done. Individual cases could be more or less.

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD


Question: Re: Nasal fracture

Dr. Bermant,

About 10 days ago, I broke my nose. The distal tip of my nasal bone was broken. I went to the emergency room and I was given an ice pack, analgesia, and anitbiotics. I did not follow up with an ENT because I did not have the money. My nose is still sore and painful. It has very slight swelling, but it is red in the site where the bone was broken. I received a small laceration from the injury, but I am not having any drainage. Is it too late to see a Doctor. Do you think there is any further injury to my nose?

Dr. Bermant responds:

This should not be construed as medical advice. I am a Board Certified Plastic Surgeon.

I prefer to see my nasal fracture patients very soon after injury as the bones tend to set in what ever position they are in quickly. I try to align the fragments by day 10-12. Other problems can be present. I cannot comment on your specific case since I have not had the opportunity to examine nor evaluate you.

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD


Question: Re: broken nose

sorry to bother you but im 18 years old i fell down and broke my nose they sent me home from the hospital no bandages or nothing what sould i do thank you m

Dr. Bermant responds:

This should not be construed as medical advice. I am a Board Certified Plastic Surgeon.

I usually do not use a bandage on broken noses. I use a splint after nasal fracture reduction. Please see that web page for more details.

There are many types of broken noses, without seeing you, examining you, nor evaluating you I cannot make specific recommendations. If you have not already done so, you can see some preliminary information on the web that I give my patients. Each doctor has their own preferences and you should follow those given to you by your doctor. Most broken noses benefit from a consultation by someone who knows about nasal fractures. This is usually a board certified plastic surgeon or Ear Nose & Throat Surgeon (Otolaryngologist). There is a time limit for reasonable reduction of fractures and treatment of septal hematoma (blood trapped under the lining of the central wall of the nose).

I hope this information proves of value.

Michael Bermant, MD


Question: Re: broken nose

dear dr. Bermant,

I fell and broke my nose about 6 months ago.The specialist told me that he could relign the bones, but the break was only slight, and would not be noticable. He said that after a period of 2 weeks it would be too late to have the bones alligned. I decided against the surgery due to being scared and thinking that my nose would not look any different.

However, my nose has set crooked and has a few bumps on it. I am having headaches, difficulty in breathing and conjestion.

If i opted to go for corrective surgery now, would that involve a comlicated surgical procedure? (even though I was told that my break was only slight?) Is it something that could be done under gas, or would I need to have a general? Would any cutting be involved, or would it be a case of breaking an then resetting?. Also, would it be classed as purely cosmetic. I am currently working in singapore where the hospital fees are gigantic. Hower, I would be covered by the company as long as it wasnt classed as being cosmetic.

I sincerely appreciate your time Dr Bermant,

J

Dr. Bermant responds:

This should not be construed as medical advice. I am a Board Certified Plastic Surgeon.

Nasal fracture as my web page describes can lead to both deformity and breathing problems. Sometimes it only takes a minimal deformity to obstruct the nose. The cartilage part of the nose can be fickle. The micro -cracks from trauma and the stresses from the skin it supports can make cartilage bend over months. Such bending can further distort the nose and worsen breathing obstruction. Septal deflection can push against the turbinates and cause blockage of the sinus drainage holes. Pressure build up in the sinuses (a sinus headache) can be the result.

Correcting nasal obstruction and deformity from trauma should not be considered cosmetic surgery. You would have to check with your own insurance company however. Some of my patients ask for other changes to their nose during that surgery Refinement of the tip, decreasing the height, as well as many other possible cosmetic choices are not usually covered by insurance. It really depends on what the patient is asking for. In such cases I suggest to the insurance company that they cover X% of the operation (depending on what needs to be done) with the patient paying for the cosmetic part of the operation. When the insurance companies cooperate, this system works best.

Your other questions require an examination and evaluation to answer. How am I supposed to make a reasonable analysis and recommendation without these essential factors? Most nasal surgery has incisions inside the nose. Some procedures uses tiny incisions on the outside.

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD

Dr Bermant,

Thank you so much for your prompt reply and advice. It is very much appreciated.

With regards,

J

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