Nasal Deformities and Fractures: What to Expect and How They’re Treated

Because the nose sits prominently in the centre of the face, it is one of the most commonly injured and fractured bones. A nasal fracture, or broken nose, can affect both appearance and function, and may also make breathing through the nose more difficult.

Although nasal injuries can be painful and sometimes alarming, many cases can be effectively treated, especially when evaluated early by a healthcare professional.

What Is a Nasal Fracture?

A nasal fracture occurs when one or more of the bones in the nose are broken due to trauma. The injury may also involve the cartilage and internal structures of the nose.

Because the nose contains both bone and cartilage, injuries can vary widely. Some fractures are mild and stable, while others may significantly alter nasal structure and airflow.

Common Symptoms of a Broken Nose

Symptoms of a nasal fracture often appear immediately after injury. The severity of symptoms can vary depending on the force of impact.

Common signs include:

• Pain and tenderness in the nose
• Nosebleeds (epistaxis)
• Swelling inside and outside the nose
• Difficulty breathing through the nose
• Bruising around the eyes or “black eyes”
• Visible change in the shape or alignment of the nose

In some cases, a collection of blood may form inside the nose on the nasal septum. This is known as a septal hematoma.

What Is a Septal Hematoma?

A septal hematoma occurs when blood collects between the cartilage and the lining of the nasal septum, which is what divides the two sides of the nose.

This condition is important to identify quickly because, if left untreated, it can damage the cartilage and lead to long-term complications such as nasal deformity or breathing problems.

If a septal hematoma is suspected, seek medical attention right away.

What Causes a Nasal Fracture?

Nasal fractures are most commonly caused by direct trauma to the face.

Common causes include:

• Sports injuries, especially in contact sports
• Falls
• Accidents or collisions
• Physical altercations or blunt force injury
• Injuries involving the mouth or jaw that also affect the nose

How to Prevent Nasal Fractures

While it is impossible to avoid every injury, certain steps can be taken to reduce the risk of nasal fractures, including:

• Wearing protective facial gear during contact sports
• Using appropriate safety equipment in high-risk activities
• Avoiding situations that may lead to facial trauma

When Should You See a Doctor?

If you suspect a nasal injury, it is important to seek medical evaluation, especially to rule out a septal hematoma or more serious injury.

You should see a healthcare provider if:

• The nose appears crooked or misshapen
• Breathing through the nose becomes difficult
• There is significant swelling or bruising
• A nosebleed does not stop
• Pain persists or worsens after injury

In many cases, the initial evaluation can be performed by a primary care provider or in an emergency department.

Evaluation within the first one to two weeks after injury allows for more treatment options. After this window, swelling and early healing can make correction more difficult.

How Is a Nasal Fracture Diagnosed?

Diagnosis begins with a careful medical history and physical examination.

A healthcare provider will typically:

• Ask how the injury occurred
• Review symptoms and overall health history
• Examine the nose for swelling, bruising, and deformity
• Check surrounding structures, including the eyes, jaw, and teeth

Sometimes, imaging such as an X-ray or CT scan may be ordered. These tests can help identify associated facial injuries, although they are not always needed to confirm a nasal fracture.

Nasal fracture diagnosis is often based primarily on physical examination and changes in breathing or appearance of the nose.

Treatment Options for Nasal Fractures

Treatment depends on the severity of the fracture and whether the bones have shifted out of position.

Options include:

Observation and Conservative Care

If the nasal bones are fractured but remain properly aligned, surgery is not likely needed.

In these cases, management may include:

• Rest
• Ice application
• Avoiding further trauma to the nose
• Monitoring for changes in breathing or appearance

Many mild fractures heal without intervention.

Closed Reduction (Non-Surgical Realignment)

If the nasal bones are displaced, they may need to be repositioned.

In some cases, this can be done in a clinic or emergency setting. A healthcare provider may:

• Apply local anaesthetic
• Gently reposition the nasal bones
• Stabilize the nose using a splint or cast

Temporary casts are often made of plastic, plaster, or similar materials and are typically worn for about a week.

This procedure is most effective when performed within the first one to two weeks after injury.

What If Surgery Is Needed?

If more than two weeks has passed since the injury, swelling and early healing may limit the options.

When this happens, surgery may be delayed for two to three months to allow the swelling to resolve fully. This helps the surgeon better assess the original nasal structure and plan the repair.

This type of procedure is considered reconstructive surgery and depending on timing and patient goals, surgical repair may focus on:

• Restoring the original nasal shape
• Improving breathing function
• Correcting structural deformities caused by injury.

Why Early Assessment Matters

Untreated nasal fractures can lead to long-term complications, including:

• Persistent nasal deformity
• Chronic breathing difficulties
• Ongoing nasal obstruction
• Cosmetic concerns

Early evaluation ensures that injuries are properly assessed and that treatment is provided at the optimal time.

Final Thoughts

A nasal fracture is a common facial injury that can affect both appearance and breathing. While some cases are mild and heal with minimal intervention, others require prompt treatment to prevent complications.

If you suspect a broken nose, visit a healthcare professional as soon as possible. With timely care, most nasal fractures can be effectively managed, restoring both function and appearance.

Contact MPENTA

If your child has experienced a nasal fracture, Michigan Pediatric Ear Nose and Throat Associates (MPENTA) can help. Our team can provide a thorough assessment, imaging, and personalized treatment options to support recovery.

Contact MPENTA today to request an appointment.