Broken Nose: Deciding Whether an ENT or Plastic Surgeon Should Repair It

by | Sep 25, 2023 | Ear, Nose and Throat

Most people don’t want to have to choose between form and function when it comes to their nose. Both plastic surgeons and ear, nose, and throat (ENT) specialists can treat/repair broken noses!  So how do you pick who is best at addressing your broken nose and not only restoring form to your nose but also proper functioning (i.e. breathing and sinus drainage)?

Broken Nose Basics

Broken Nose: Whether an ENT or Plastic Surgeon Should Repair ItYour nose is made up of three parts, with a bony pyramid in the top third of the nose, hard cartilage in the middle, and soft cartilage at the bottom. A nasal fracture, more commonly called a broken nose, happens when the bone in the nose cracks or breaks. Most often, a broken nose affects the upper third of the nose, the bony pyramid.  However, if left too long then the middle 1/3 and bottom 1/3 follows the break above.

Broken noses are the result of trauma, with common causes including sports injuries, falls, vehicle accidents, and physical violence. Initial signs of a broken nose may include:

  •     Pain
  •     Bleeding
  •     Swelling
  •     Crooked appearance
  •     Bruising around the nose
  •     Bruising under one or both eyes
  •     Difficulty breathing through the nose
  •     A feeling of blockage in the nose

If you have emergency symptoms of a serious traumatic head injury, uncontrollable bleeding, or difficulty breathing through both the mouth and nose, seek emergency care right away.

Even without a more serious head injury, it’s important to address a broken nose fairly quickly. If a broken nose heals without being fixed, other parts of the nose may collapse or curve, causing long-term cosmetic or breathing issues.

An ENT or Plastic Surgeon for a Broken Nose?

Sometimes after a broken nose, patients will experience problems both with cosmetic deformities of the nose but also functional issues like recurrent nosebleeds, unilateral or bilateral nasal obstruction (i.e. breathing problems), sinus headaches or recurrent sinus infections as well as new-onset snoring or sleep problems.   So—what kind of a specialist should you see, a plastic surgeon or an ENT specialist?

Both ENT physicians and plastic surgeons are qualified to do a nasal fracture repair, which is a surgical realignment of the nose after it has been broken. However, the ENT specialists at C/V ENT Surgical Group are specialists at treating both the cosmetic deformity of the nose but also the functional issues of the nose so you don’t develop further breathing or sinus problems.  This should be done with 2-4 weeks of the injury to allow the best long-term result. This corrects the problem in about 80-90% of cases.

However if the injury happened over 3 months prior and the nose is deformed and having significant breathing or drainage problems, then an ENT specialist or Facial Plastic Surgeon at C/V ENT Surgical Group may need to perform a septorhinoplasty, which reshapes and repairs the outward appearance of the nose. A broken nose can sometimes alter your appearance significantly, so rhinoplasty may be desired. It’s often considered cosmetic, however, and may not be fully covered by insurance. But if you have breathing concerns from a broken nose, our surgeons work with insurance companies to try to get at least partial insurance coverage for the procedure.

Rhinoplasty is also routinely performed by our Facial Plastic Surgeons at C/V ENT Surgical Group who do extra training after their ENT residency solely in facial plastic surgery of the face and neck.   At C/V ENT Surgical Group, we have facial plastic surgeons and ENTs who are experts at rhinoplasty for a broken nose.

Some specific conditions resulting from a broken nose require surgery from an ENT specialist:

  •     Deviated septum: The inside of the nose is divided in half by the nasal septum, made up of thin bone and cartilage. When the septum is pushed out of place to become crooked, it’s known as a deviated septum and can cause a number of problems. As many as 80 percent of people have a deviated septum (often not due to a traumatic injury such as a broken nose.) Some people aren’t aware they have it, but if it is causing breathing problems, sleep apnea, recurrent nosebleeds or sinus infections a septoplasty surgery is needed to correct it.

Sometimes after a broken nose, patients will have a septorhinoplasty, which is both the repair of a deviated septum and a rhinoplasty to address outward cosmetic concerns of the nose. This can be done by an ENT with facial plastic surgery training or by an ENT and a facial plastic surgeon working together.

  •     Septal hematoma: This can occur when blood leaks into the septum itself and pools there. Those with a septal hematoma may experience a blockage of one or both nostrils, bruising, and painful pressure. It should be treated right away, as we’ll need to drain the septum and repair the injury to prevent further complications.

C/V ENT Surgical Group Nasal Fracture Expertise

The physicians at C/V ENT Surgical group specialize in repairing broken noses with both function and cosmetics in mind. With extensive experience in facial plastic surgery and ENT specialization, our experts can address both breathing difficulties and appearance concerns after a broken nose.

It’s a good idea to contact us in a timely manner to minimize long-term risks or complications. If you are treated soon after the fracture, the chance of needing a rhinoplasty later on is significantly minimized.  If surgery is needed for a nasal fracture, our outpatient procedure usually takes less than an hour, we can repair your broken nose, with the utmost care taken to preserve the appearance and restore proper breathing. Most patients don’t require nasal packing and experience only minimal discomfort and bruising.

Give us a call today at one of our three Los Angeles area locations:

West Hills: (818) 888-7878

Encino: (818) 986-1200

Westlake: (805) 371-0004