Beverly Hills Plastic and Cosmetic Surgery “Tip of the Day” from Dr. Francis R Palmer, III Beverly Hills Plastic and Cosmetic Surgeon. Nasal Trauma
Rhinoplasty and Nasal Trauma:
I’ve received numerous questions about hitting, bumping or injuring the nose after a Rhinoplasty and I felt the following information would be useful. It is very true that your nose is quite vulnerable after Rhinoplasty. It can remain so for weeks depending on what was done to your nose during the Rhinoplasty. Here are some helpful tips to remember:
1. Avoid any contact during the first month following your Rhinoplasty. Avoid sports and horsing around with friends over this period. Should your nose get bumped or hit hard enough for it to hurt, you see stars, bleeding or significant swelling occurs…immediately contact the plastic surgeon who performed your Rhinoplasty for specific instructions and advice.
2. If you haven’t had a Rhinoplasty and you are hit in the nose hard enough to cause the symptoms described above, it’s a good bet that something has been torn, craked or broken in your nose. This does not mean that you will need a Rhinoplasty but you should: Go to an ENT or plastic surgeon in the first 24 hours to have the nose examined and evaluated. An X Ray only reveals whether the nasal bones were broken or not …the problem is that much of the nose is cartilage which does not show up on X Ray. The most important thing after nasal trauma is to rule out a septal hematoma.
The septum can die in as little as 24 hours after nasal trauma and if this occurs it will cause permanent nasal deformity. Only an experienced doctor such as an ENT or a plastic surgeon will most likely be able to examine your nose and identify whether or not a septal hematoma exists. I believe that most ER doctors do not have the same ability and thus a septal hematoma may be overlooked in the ER unless an ENT or Plastic Surgeon specialist is called to see you.
If a septal hematoma has been ruled out, the nose can be treated expectantly with ice and pain medication. Over the following several weeks, the aesthetics of the nose can be re-evaluated because what looked crooked at 3 days may appear straight at 3 weeks. I am not an advocate of immediate closed nasal reductions (where they place a metal object up your nose and attempt to reduce broken nasal bones or torn cartilage). I believe this to be a barbaric procedure that has little chance of correcting the aesthetic problems related to a nasal fracture. I believe it’s better to have an initial nasal examination to rule out a septal hematoma and then follow the injury at 3 weeks at which time a Rhinoplasty can be performed to correct the problems should they still exist.
You can read more about Rhinoplasty here:http://www.beverlyhills-plasticsurgery.com/Rhinoplasty.html
Dr. Francis R Palmer, III