Broken noses can be difficult to diagnose. The bones are very thin, so x-rays are not helpful in determining if a nose is broken. Yet I still see patients in my office who are x-rayed by well-meaning ER physicians. My first piece of advice for you today- if you go to the ER with a possibly broken nose, and the doctor orders an x-ray, politely decline. It’s just not useful, and whatever specialist they refer you to (Plastics or ENT are the options) will not need the films. Or the ER may order a CT scan- this is useful if the doctor suspects you may have broken bones in your face other than your nose. But if the nose is your only injury, CT is overkill.
Here’s my second piece of advice for you today: the important question is actually not if the nose is broken, but whether or not it needs treatment. A broken nose may need to be treated operatively for two possible reasons:
- If the nose is crooked. It may appear flattened, or pushed off to one side. Check out the photo to the right to see what I mean- this nose is definitely broken. (Does anyone else wonder why Shutterstock has stock photos of broken noses?)
- If there is breathing obstruction. There will be some breathing obstruction for the first 7-10 days due to swelling, but this should resolve as the swelling goes down.
Treatment of a broken nose involves a trip to the operating room, where your nose and septum are straightened out. This should be done within about three weeks of the injury, or the bones will have started to heal. Afterwards you have a splint over your nose, and packing inside of your nose. This packing stays in about a week, and the external splint stays on for about two weeks.
If your nose looks like it did before you got hit, and you are not having difficulty breathing, then you don’t need treatment even if your nose is actually broken. It will heal on its own over a period of about 6 weeks. I would recommend not getting hit in the face during that time period, although honestly I have a general policy against getting hit in the face at all.
Have you ever had a broken nose? How did it happen?