Is My Nose Really Broken?

From school boys who have been in their first fist fights to middle-aged, weekend jocks playing Rugby, the question is often the same:

“Doctor, is my nose really broken? Will I need a nose job?”

The question about a fractured nose is pretty common because the nose:

• Protrudes from the face
• Contains fragile, eggshell thin bones
• Comprises almost 40 percent of all facial injuries

The basic dead-bang giveaway that a nose is really broken is changed shape. In a true broken nose, you’ll also feel a change in breathing and may see some black and blue marks on your face with some swelling of the nose. You will likely have a nosebleed, too, which comes from the nasal mucosa, a type of moist tissue found inside the nose.

The most common reasons for broken noses, Rugby notwithstanding, include:

• Other sports injuries like “touch” football
• Falls
• Car accidents
• Fighting, scuffles, assaults, brawling, melees & donnybrooks

The most serious situation is if you can’t breathe. Then, you’ve got real trouble because the nose’s chief function is passing warmed, filtered air to the lungs. Mouth breathing brings its own set of problems, so being unable to breathe through the nose constitutes a situation close to a nose emergency.

It usually takes about a week for swelling to resolve so that a nasal surgeon can tell – through his sense of touch – what has happened to the nose bones.

A good exam would include a serious look up inside the nose, too.

For instance, an injured nose could have a septal hematoma, a bruise or bleeding from the septum, that thin wall of cartilage that separates your two nostrils. An untreated septal hematoma can lead to destruction of the septum and a condition known as saddle nose deformity.

Plus, there are many different parts of the nose that can be fractured. That’s why it’s best to have it examined by an experienced nasal surgeon who really knows the anatomy of the nose.