Broken Noses

Dr Jason Roth (MED0001185485) — Specialist Otolaryngologist & Head and Neck Surgeon, specialist registration in Otorhinolaryngology, Head & Neck Surgery.

Injury to the nose is common and can affect both the appearance and function of the nasal airway. Prompt assessment after nasal trauma is important — the timing of treatment significantly affects the options available and the complexity of any surgical repair required.

All surgery carries risks — read the full rhinoplasty risks page →

What Structures Can Be Injured?

The nose is supported by a framework of delicate cartilages and bones held together by ligaments. Any of these components can be affected by nasal trauma:

The nasal bones
The bony or cartilaginous nasal septum
The upper lateral cartilages (supporting the middle third of the nose)
The lower lateral cartilages (supporting the nasal tip)
The nasal skin and soft tissue

The severity and pattern of injury determines what treatment is needed. Many injuries involve only the nasal bones and can be managed with a relatively straightforward manipulation. Others involve the septum, cartilages, or tip supports and require more extensive repair.

Urgent Assessment After Nasal Injury

Seek urgent assessment if you suspect a septal haematoma

A septal haematoma — a blood clot forming between the nasal septum and its lining — is an urgent complication of nasal injury that must be drained within approximately 48 hours to prevent permanent damage to the septal cartilage. Signs include a soft bluish swelling visible in both nasal passages, increasing pain, and nasal obstruction shortly after injury. If suspected, seek urgent medical assessment.

Even without a haematoma, early assessment after nasal injury is valuable — it allows the initial degree of deformity to be documented before swelling obscures the picture, and helps determine whether early intervention is possible. Applying ice packs to the nose in the first 24–48 hours can help reduce swelling sufficiently for a more accurate assessment at a follow-up visit seven to ten days after the injury.

Timing of Treatment

Within 3 weeks

In the first two to three weeks after nasal injury, the nasal bones have not yet set in their new position. During this window, displaced bones can often be relocated under anaesthesia without needing to be formally re-fractured. This is a simpler procedure than rhinoplasty and carries less risk.

After 3 weeks

Once significant scar tissue has formed and the bones have set in their displaced position, correction requires a formal rhinoplasty with osteotomies to re-fracture and reposition the bones. This is a more involved procedure and is typically planned at least three to six months after the initial injury to allow full healing.

Surgical Treatment

Most nasal injuries that require surgical correction are treated under general anaesthesia. Dr Roth generally aims to address all injured structural elements in a single procedure where possible — the nasal bones, septum, and any cartilage damage — rather than staging multiple operations.

Where the injury is limited to the nasal bones, a manipulation under anaesthesia may be all that is required. Where the septum is also injured, a septoplasty is added. Extensive injuries to the tip and cartilaginous supports of the nose may require a full rhinoplasty with cartilage grafting. Where both a functional septal correction and external cosmetic correction are needed together, this combined procedure is called a septorhinoplasty and may attract Medicare rebates for the functional component.

Nasal injuries may be eligible for Medicare and private health insurance rebates where they represent genuine post-traumatic deformity. This will be discussed at consultation.

Dr Jason Roth | MBBS, FRACS (ORL-HNS) | MED0001185485
Specialist Otolaryngologist & Head and Neck Surgeon
Specialist registration — Otorhinolaryngology, Head & Neck Surgery
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