Traumatic nasal reconstruction

About the procedure

Nasal trauma is a leading cause of cosmetic deformity and breathing problems. Whether the trauma is minor or significant, any damage to the nasal bones and nasal septum can change airway dynamics and also lead to alterations in appearance. Rhinoplasty for nasal trauma, or traumatic nasal reconstruction, can take place any time after the initial injury. Typically, it is better to attempt a repair immediately after injury (if possible) as this can reduce the deformity in the long term and decrease the chances of the patient needing a more extensive surgery.

However, sometimes it is not possible to repair the nose immediately after surgery, or occasionally the immediate repair does not fully correct the deformity and breathing problems as well as alterations in appearance can result. Common manifestations of nasal trauma include the classic “C” or “S” shaped nasal deformity, dorsal nasal collapse or “saddle nose” deformity, septal perforations, and occasionally collapse of the nose.

In order to improve the appearance of the nose following nasal trauma and improve breathing, Dr. Hirsch will use a variety of suture techniques and cartilage grafting techniques such as spreader grafts, spring grafts, columellar strut grafts, batten grafts, crural grafts, and other techniques to reinforce the existing cartilage and help maintain the open airway. Dr. Hirsch will always tailor your treatment to your specific symptoms, so an extensive history and physical exam is always part of your first consultation with Dr. Hirsch.

After surgery, depending on what was performed, a nasal splint (on the outside of the nose) or nasal stent (on the inside of the nose) may be used for 3-7 days to help minimize swelling after surgery. Traumatic nasal reconstruction patients may experience swelling of the nose and occasionally bruising around the eyes and cheeks for 1-3 weeks following surgery. Swelling of the nose, especially in revision traumatic nasal reconstruction when extensive reshaping is performed, can take several months to resolve. However, pain after traumatic nasal reconstruction is usually mild, and patients are able to resume normal activities 1-2 weeks after surgery.

Frequently asked questions about traumatic nasal reconstruction:

I broke my nose a few days ago and it was fixed, but it still looks broken. When should this be repaired?

In general, it is better to fix a fractured nose within the first 24-72 hours of the injury. Up to 7-10 days, the fracture fragments are still mobile and can be manipulated back into position. After 10-14 days, the fracture segments have begun to heal in place and it becomes more difficult to move them back into position. As further time progresses, it may become necessary to wait until the nose is fully healed (6-12 weeks) before performing a definitive traumatic nasal reconstruction through an open rhinoplasty approach if necessary.

Is traumatic nasal reconstruction covered by insurance?

Reconstruction of a newly fractured nose is usually covered by insurance. Some insurance companies will cover reconstruction of a nose that was damaged by trauma, especially if you are having breathing problems as a result. Dr. Hirsch and his team will help you determine if your traumatic nasal reconstruction surgery is covered by your insurance carrier.

I broke my nose in a car accident as well as my jaw. Can Dr. Hirsch fix my broken jaw as well as my nose at the same time?

Yes, Dr. Hirsch can repair your broken nose as well as your broken jaw. If you have other facial fractures that need repair such as orbital fractures or midface fractures, Dr. Hirsch can repair these at the same time as you traumatic nasal reconstruction as well.

Additional resources about tramatic nasal deformity reconstruction

Feel free to browse the following links to learn about the correction of traumatic nasal deformities:

https://www.american-rhinologic.org/