Sunday, June 9, 2013

Nose Surgery after Trauma

A traumatic accident may leave your nose crooked, with a scar, or deformed in another manner. Nose surgery or rhinoplasty after trauma is all about timing. A nasal bone fracture or broken nose that demonstrated evidence of bony deviation may require a closed reduction with external stabilization or a cast. This is similar to the trainer “cracking” the boxer’s nose over to make it straight in the boxing ring as we have seen in the movies. The surgeon however does this with the patient under anesthesia. This straightens the nasal bones and may improve breathing. Typically, a closed reduction of nasal bone fracture needs to be done within 2 weeks of the injury. Otherwise, the nasal bones may start to heal and mend in the deviated position making reduction more difficult.

With patients who have a chronically deviated nose or crooked nose due to an injury many years ago, the nasal bones may need to be fractured in a controlled manner under anesthesia to straighten them. In addition, cartilaginous changes with grafts and sutures may need to be made in order to straighten the cartilage of the nose.

One thing I always tell my crooked nose patients is that your nose will be perfectly straight on the operating room table. However, cartilage has memory and wants to move back to its original position. If we sleep on our ear pulled forward, it will not remain that way the following day. There are many things to do to prevent the cartilage from moving back with sutures, scoring, and grafts but I always inform these patients that their nose will be “straighter” for certain long term.

Dr. Funk is a top rhinoplasty surgeon or nose surgeon in Houston, Texas.