How can I fix a broken nose from 1 year ago?Ear, Nose & Throat Plastic Surgery Sport Medicine
I injured my nose 1 year ago while playing basketball. I've just realized that my nose is slightly deviated, and breathing from the right nostril is difficult. I am looking to see what I can do about it. What treatment options are available for correcting a broken nose, and is treatment covered by insurance?
Thank you for your question on deviated nose with difficulty breathing after a basketball injury.
The nose is one of the most commonly fractured bone in the face. This is often as a result of road traffic accidents, accidental falls or from altercations. In your case its is probably from an elbow or being hit by a ball during basketball. The severity of the injuries to the nose can also vary from simple contusions to complex fractures.
Not all broken noses will require surgery. If the fracture is straight and minor and there is no deviation of the nose, surgery is not required and the bones will heal in-situ. Painkillers and antibiotics may be all that is required. However, if it is a true nasal fracture, it does take 2 weeks for the bone to become stable and about 6 weeks to heal completely. During this period of time, it will be advisable to avoid wearing glasses and engaging in contact sports.
Sometimes the swelling from the injury can mask the underlying deviation of the nose or underlying septal injury. Besides the nasal bones, the septum (comprising of bone and cartilage) inside the nose also needs to be considered. In instances where the septum is deviated or there is difficulty breathing, septorhinoplasty may be required. In your case, as the injury was 1 year ago, the swelling would have subsided and you would have noticed this deviation and nasal blockage some time back.
For my patients who present early with a nasal fracture that is displaced, I usually recommend a closed reduction (resetting of the nasal bones and septum, without any other intervention) within the first 14 days from injury. This is especially so if the deviation is troubling to the patient or if breathing is obstructed. Occasionally a septorhinoplasty may be indicated. If there is persistent deviation of the nose, a formal rhinoplasty is usually performed 9-12months after the injury. So you would fall in the latter category.
Depending on the severity and whether the septum (cartilage within the nose) is deviated, you may benefit from surgery to realign the nasal bones and cartilage structure to correct the broken nose and also removal of the broken septum to improve breathing.
At this juncture, we should perform a CT Scan and review your old X-ray to have an idea of what needs to be corrected. Depending on your insurance policy, this should be covered, but you would have to check with your provider about the claim periods.
In addition, we are able to perform 3D realtime simulation of before-after impressions for rhinoplasty. I would recommend seeking an in-person consultation with a board-certified plastic surgeon who has a 3D-simulation software so that you can have a better idea of what your results would look like.
I hope I have answered your queries. Have a great week ahead!
Dr. Terence Goh
Plastic Surgeon, Singapore
The information provided is purely for educational purposes and does not constitute medical advice or create any physician/patient relationship. Results may vary between individuals.
Your nasal deviation is most likely linked to a nasal fracture sustained from your basketball game. If you got hit hard enough during your game, it can cause your nasal bone or septum to break and if left untreated, it is possible for it to heal on its own and eventually settle as a deviated nose. Internally, a deviated septum will cause breathing obstruction.
A deviated nasal bridge tends to slant towards one side. That slant causes your nose and septum to collapse towards one side and it reduces the size of your nasal airway. With a smaller size and squished airway, it allows for less air flow resulting in nasal obstruction and hence you experience breathing difficulty or for some individuals, it feels like they have a perpetually blocked nose. Before devising a treatment plan, it is important to figure out which is causing your nose from deviating – nasal bone or septum. To get a clear picture of your current nasal structure, I would recommend that you undergo X-ray or CT scan and that would give plastic surgeons a clear indication of your condition.
As you have mentioned that your injury was sustained about a year ago, it should have healed completely by now. Since the nose healed in a deviated position, non-surgical treatments may not be applicable for your case. Any proposed treatment options to realign your nose bridge would likely be surgical unless the X-ray or CT scans shows otherwise. If there is a clear indication of nasal deviation, your treatment can be covered under insurance, but I would recommend that you check with your insurance company for more details on your policy and coverage.
I hope my reply helps.
Dr Por Yong Chen
The trauma from the basketball incident may have caused a missed fracture that healed, but with the nose bone in a deviated or depressed position. The external deviation though slight, may be associated with an internal nose bone deviation that is more severe. Thus, breathing from the right nose can get difficult if the air passage is blocked.
This is a very common condition that we see often, and surgery to the nose bone to improve the breathing space for the patient is covered by insurance. Many mild external nasal deviations are corrected when the internal deviation is corrected - we do not need any external incisions on the nose.
Occasionally, we need to also do an external approach if the external deviation is severe - even in those cases, the external incision is only about 3 mm length and hidden on the under surface of the nose and thus not visible.
If you have trouble breathing from your nose you most likely have a deviated septum from your nasal trauma. This can be confirmed on clinical examination but a CT scan would be helpful too.
Since your injuries are due to trauma and they are causing functional problems, your insurance would most likely cover the cost of treatment. This can be confirmed prior to surgery.
The treatment would involve removing the deviated part of your septum and straightening your nose. The surgery is done under general anaesthesia, so you won't feel any pain during the operation. Your nasal bones may need to be re-broken in order to straighten them.
Hope this helps.
I'm sorry to hear about your basketball injury.
When I deal with broken noses in a non-acute setting, such as yours, there are 2 aspects that we have to address - the functional aspect (difficulty in breathing from the right nostril) and the cosmetic aspect (nose is slightly deviated).
I can address either one or both surgically and it would depend on whether you are bothered sufficiently as the more we correct, the higher the complexity of the surgery and the longer the downtime.
I perform the corrective surgeries as a day surgery and you have an option of either full General Anaesthesia or deep sedation.
I won't address the technical aspects as the other surgeons have given a good overview. And yes, the functional nature and the traumatic origin of the injury qualifies you for insurance and medisave coverage.
Dr Samuel Ho