Patients come to my office all the time wondering if they’ve broken their nose.
The short answer is that it doesn’t matter … kind of 🙂
What do you mean ‘it doesn’t matter?’
First let me qualify that statement. Your nose isn’t like other bones in the body. It isn’t a weight bearing bone or joint. So it isn’t like your leg, foot, or arm where immediate action is necessary. In most nasal fractures, NO action is needed. We mostly recommend avoidance of rigorous activity and contact sports for about 4-6 weeks. And if you can avoid wearing glasses that would also be helpful to avoid depressing one or both nasal bones.
So what does matter?
Does it look ok? Is there a bump, a cut or is it crooked?
If there are any of these, then it’s more likely that there has been a nasal fracture. Also if there’s a nose bleed or if there’s bruising or ‘raccoon eyes’, then a fracture probably happened.
If any of the above has happened then it’s a good idea to see an ENT, or a facial plastic surgeon as soon as you can. And if you can’t, go to your nearest ER or urgent care.
If there has been a change in your ability to breath through your nose it’s a good idea to see a ENT or facial plastic surgeon.
It might not mean that there’s a nasal fracture, but there might have been an injury to the septum that needs to be evaluated.
Timing is important only from the perspective of intervention.
If straightening of the nose needs to be done, physicians have a 10 day window from the time of injury to reset nasal bones in a minimally invasive way. Sometimes we use the 14 day mark as the last possible day for a closed reduction.
If it’s after the first window of opportunity, then we typically wait a full 6 weeks from the time of injury to reevaluate. At that point most of the swelling has gone down and then we can more appropriately assess the need for intervention.