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.
