The nose is the most important part of the face. Even minimal changes in the shape of the nose can completely change a person’s appearance. Therefore, rhinoplasty is one of the most common plastic surgeries in the world. As a rule, people want to make their nose more graceful, thinner, remove a hump or correct the tip - in a word, first of all we are talking about beauty. But there are people for whom rhinoplasty is truly a necessity. First of all, this applies to situations where the nose had to endure trauma.
Many patients are interested in the question: if trouble happens and the nose is broken, at what point is it better to contact a surgeon?
Our advice: it is best to contact our clinic when the injury is still relatively fresh. If you have a broken nose, it is best if you see a doctor within 10 days. During this period, it is possible to restore the original shape of your nose, since during this time the fracture has not yet had time to heal (and often it itself does not heal correctly). There can be many types of such fractures: rotation to one side, hump, flattening, etc.
Such fractures occur as a result of sports injuries - in professional wrestlers, for example. There is even such a term as “boxer nose”. In this case, it is worth soberly assessing whether you are going to continue playing sports. If not, then you should go to the clinic and get advice on restoring the shape of your nose. In this case, it does not matter too much how long ago your nose lost its original shape - a good aesthetic result can be obtained even if the intervention occurs several years after the fracture.
What will the operation give and what types of interventions are possible?
First of all, after a fracture, the nose may lose its attractive shape - our doctor will try to restore it. If the fracture is old and the bones have healed incorrectly, the operation will require a very serious and relatively traumatic one - most likely, the method of open rhinoplasty .
This method is good because it gives the surgeon greater freedom of action if some parts of the bone need to be chipped, restoring symmetry. It also allows you to qualitatively restore nasal breathing. However, there are also disadvantages: after such an operation there is more blood loss, the healing period is somewhat longer, plus there are postoperative scars (although the cosmetic suture becomes less noticeable relatively quickly).
Less serious defects - for example, a hump, asymmetry - can be corrected using closed rhinoplasty - in this case, there is no need to expose the deep structures; we will operate on your nose using special instruments, without making external incisions. Even with a closed technique, the aesthetic results can be very impressive. And besides, in this case the seams will be internal - that is, those around you will not even know that an intervention was carried out.
Besides the fact that a broken nose is unsightly, it can also be harmful to health . A fracture often leads to a deviated nasal septum and disruption of normal breathing. That is, the problem is not only aesthetic, but also purely medical. If after an injury you have any peculiarities in the functioning of the respiratory system - the effect of constant nasal congestion, snoring, etc. – after plastic surgery, you will not only enjoy the reflection in the mirror, but you will also be able to breathe normally again.
Another method that will help restore a once damaged nose is nasal tip plastic surgery .
This type of intervention is carried out, for example, if after a fracture or simply a strong blow, your cartilage was damaged and crushed, the tip of your nose was flattened, sank down, etc. Nasal tip plastic surgery can also be performed in an open or closed manner - you can determine the specific method that is suitable for your case after consultation with our surgeon. The amount of intervention here is not as large as in traditional rhinoplasty.
Symptoms of a fracture and indications for surgery
It is important to identify a nasal fracture soon after the injury occurs. The most reliable sign is visible deformation of the bones, as well as their significant displacement or the ability to see them in an open wound, but if the injury is not severe, it will not be possible to determine the presence of a fracture by eye.
Symptoms of a fracture also include:
- Nosebleeds and hematomas in the nose and eyes
- Swelling of the nose
- Difficulty breathing
- The appearance of red veins on the eyeballs
- Recession of the nose inward (with damage to the septum)
- A characteristic crunch of bones upon palpation, called crepitus
Important! This symptom should only be checked by a specialist, otherwise irreparable harm to health can be caused.
To unambiguously determine the injury , an X-ray, rhinoscopy or MRI are prescribed. To determine the severity of harm, the circumstances of the injury, associated injuries, and the severity of the bleeding are taken into account. It is worth remembering the possible infection of the wound with an open fracture, as well as long-term consequences, for example, loss of smell.
To provide first aid to the patient, it is necessary to apply a cold compress (if possible, through an antiseptic bandage), as well as placing the victim in a position in which his head and body are slightly tilted forward to prevent blood from flowing down the respiratory tract. It is necessary to transport the victim to the emergency room as soon as possible.
To treat a fracture, bone repositioning may be prescribed - an operation during which bone fragments are moved into place by a traumatologist.
Undoubted indications for surgery are noticeable displacements:
- A displacement of the nasal septum to the left or right indicates rhinoscoliosis;
- Partial retraction of the nasal bridge is called rhinolordosis;
- Platyrinia is manifested by pressing the nose inward, making the nose shorter and wider;
- Formation of an obvious hump;
- Damage to the sinuses or deformation of the external nasal passages
What are the risks of the operation?
Like any surgical intervention, rhinoplasty has a number of limitations and even direct contraindications: severe chronic diseases, blood clotting disorders, inflammatory processes in the acute phase. However, if you are therapeutically healthy, most likely you will tolerate rhinoplasty well.
It is especially worth noting those patients who are terrified of surgery, fearing that after it the result will be unpredictable. These fears are unfounded: before deciding on a specific intervention method, our doctor always analyzes the current state of affairs with the patients (carefully examines the damaged area, determines the amount of intervention required, whether there are breathing problems, etc.) and models the desired result. Thus, you can “try on” your future nose at the stage of preparation for surgery.
Classification of fractures
Depending on the severity of fractures, doctors classify them as follows:
- by skin integrity: open (can be recognized visually) and closed;
- according to the position of the bones: nasal fracture with displacement and without displacement.
Let’s take a closer look at the second classification and look at how long it takes for a closed nasal fracture to heal without displacement, and how long with displacement, and talk about the danger of open fractures.
An injury with a violation of integrity, during which the anatomical position of the bones was not disrupted, is called a non-displaced fracture. It will be difficult for a non-professional to diagnose it externally. He can only assume its presence by recognizing indirect symptoms, such as pain, swelling, bruising at the site of injury. The final conclusion about the nature of the injury and the location of the bones is made by the traumatologist after examination and based on X-ray data.
How is rehabilitation going?
Rhinoplasty requires a relatively long recovery: you will need to wear a special bandage for about a week, and in order for your nose to retain its new shape, special tubes and splints will support it in the first few days. This creates some discomfort, but not too significant.
Approximately a week after the intervention, postoperative swelling gradually subsides, and the first results can be assessed. However, your nose will completely heal and recover in about a month or two, and in about six months all the changed structures will be completely fixed - this will be the final result.
It is very important to follow strict rehabilitation rules at first. You can’t blow your nose too hard, or even just sharply touch your nose, otherwise all the surgeon’s efforts will be in vain and a repeat operation will be required.
How long does it take for a broken nose to heal?
A nasal fracture, like any other, requires competent and comprehensive treatment. However, the anatomical features of the nasal bones in case of minor injuries greatly facilitate healing. For example, due to the fact that the nasal bones are motionless and have no joints, the risk of being injured again is reduced, and good blood supply in this area provides nutrition to the tissues and stimulates their fusion. Often, with timely assistance, it takes about three months to heal a simple closed fracture, and up to six months to recover from an open fracture (in especially severe cases, long-term treatment may be required for up to a year).
It is important during the treatment process to pay attention to rehabilitation procedures, which should be carried out in parallel with the main therapy. So, there are a number of recommended activities that will help speed up recovery:
- UHF therapy. It has an anti-inflammatory effect and promotes tissue restoration.
- Treatment with infrared radiation lamps. This procedure is good for getting rid of infection, which is especially important when it comes to an open fracture.
- Electrophoresis. Electrical impulses accelerate metabolic processes in tissues, which, in turn, catalyzes the regeneration process.
Each of these procedures has its own advantages and disadvantages, and only a qualified doctor can choose the appropriate type of physiotherapy based on the requirements in each specific case.
Incorrect rehabilitation measures, as well as incorrect treatment, can cause deviations from normal recovery.
Treatment [edit | edit code ]
- Outpatient treatment - if the fracture is not severe, the doctor can perform initial treatment and release the patient for outpatient treatment. Physiotherapy and a course of antibiotics are prescribed.
- If a fracture occurs with the formation of bone fragments or with displacement, then they resort to repositioning the fracture (connecting bone fragments). Sometimes it is possible to set (set) the bones in place with two movements of the fingers. If there is retraction of the bone, a special tool is used - an elevator (elevatio - to raise) [8][9].
- For severe fractures, rhinoplasty is performed. If the nasal septum was also affected, they first resort to the septoplasty procedure, since a displaced septum will not allow the external nose to be fixed in the correct position. After surgery, a fixing plaster bandage is applied to the nose for 10-14 days.
Features of treatment of fractured nasal bones
Exactly how a traumatologist will act in the event of a fracture of the nasal bones directly depends on the severity of the injury. Usually, when there are no special indications for this, traumatologists try to limit themselves to conservative therapy. But there are also cases when surgery cannot be avoided. These include open fractures with displacement or comminuted fractures. For such injuries, when the nasal bones are displaced and can put pressure on blood vessels or nerve bundles, prompt repositioning of the bones is indicated. It is often performed under general anesthesia as the procedure is very painful.
If the bone shift is not critical and the skin is not damaged, the doctor numbs only the injured area and applies a fixing bandage to the nose. In cases where there is a risk of infection of an open wound, additional therapy is required, such as injections of antibacterial drugs, vasoconstrictor drops, etc.
Specifics of treating a fracture in a child
Children become emergency room patients no less often, and sometimes even more often, than adults. In a child’s body, the processes of forming a strong bone skeleton are still incomplete, and therefore the bones remain fragile. Despite this, children are much more mobile and susceptible to injury than adults. Therefore, if a child breaks or bruises his nose, he should immediately consult a doctor.
Externally, a broken nasal bone can be recognized by the so-called sunken nose. The difficulty of treating fractures in children is that incompletely formed bone and cartilage tissues prevent the traumatologist from reducing the fracture and increase the operation time. In addition, in addition to the fact that the child feels pain during examination and treatment, he is also often afraid of the doctor. Therefore, a pediatric traumatologist needs to be not only a specialist in the field of bone treatment, but also understand the child’s psychology. However, it should be noted that a nasal fracture in children heals quite quickly, provided that first aid was provided correctly and in a timely manner. Typically, treatment and rehabilitation for a broken nose takes two to four months.
First aid
This issue deserves special attention. We have already looked at what the signs and symptoms of a broken nose are. First aid should be aimed at relieving swelling and pain. It is best to use a cold compress for this purpose. You can also apply ice to the damaged area. An important measure is to stop bleeding. To do this, the victim must take a standing or sitting position. The head should be thrown back as much as possible, and the nostrils should be pinched. After this, cotton swabs soaked in hydrogen peroxide should be placed in them.
If the nasal fracture is open, the injured surface should be treated with antiseptics. This will help prevent infection from getting into the blood. To relieve acute pain, an adult should be given one painkiller tablet. This will reduce the likelihood of painful shock. After providing first aid, the victim must be taken to the emergency room. There he will be provided with professional medical care and prescribed appropriate treatment. Do not try to set damaged bones yourself. Such actions can cause serious harm to the health of the victim and cause serious complications in the future.
Results
In conclusion, it should be said that when faced with a broken nose, it is very important to act correctly and without panic. If the victim is conscious and there are no visible injuries other than swelling and bruising, apply cold to the injury site and take the person to the emergency room. If a person loses consciousness due to a blow, the first thing you need to do is bring him to his senses. To do this, you can let him inhale vapors of ammonia, or, when this is not possible, put the person so that his legs are higher than his head, and rub his earlobes.
In the case of an open fracture, which is accompanied by bleeding, it is necessary to stop the bleeding using a tight bandage (however, applying it directly to the damaged area is strictly prohibited!) and wait with the victim for the arrival of an ambulance. Remember that you should not try to set a fracture or, in general, influence the position of the bones in any way, because without understanding the internal nature of the injury, you can only harm the person more. Correctly provided first aid is the key to successful treatment in the future.
Doctors' opinion
Despite the fact that nasal fractures are a fairly common phenomenon, doctors do not advise neglecting their diagnosis and treatment. Traumatologists are unanimous in the opinion that unqualified assistance for such an injury, and, moreover, the lack of assistance, can cause both “ordinary” (inflammation of the nasal mucosa, difficulty breathing) and very serious (sepsis, encephalitis) complications. That is why, even when it seems to you that the injury is trivial and may well go away without outside help, you should seek the advice of a doctor.
