Broken Nose - Rhinoplasty Clinic Sydney

Gemma’s Before and After Pictures

July 7, 2015 By @RhinoplastySyd

rhinoplasty-before-and-after-pictures-female

Rhinoplasty summary

This lady requested several changes to her nose, to address issues that developed after a fracture. For cultural reasons this lady requested that we maintain her mild nasal ball tip if possible. The before and after pictures are displayed in the slideshow.

Patient concerns

Appearance

Nasal bump
Nasal bridge deflection to the right hand side
Nasal length too long

Function

Breathing problems
Nasal congestion and obstruction

Surgical technique

To address her concerns this lady underwent an open structure rhinoplasty, nasal septal reconstruction and turbinoplasties.

After rhinoplasty surgery

The concerns in terms of appearance and function are addressed. After rhinoplasty the nose is straighter and the bump is removed. The tip is deprojected and uprotated, with preservation of the tip character. Overall the nose has a natural appearance in keeping with the facial features. The nasal airway is improved and breathing is easier.

Nasal Fractures

May 4, 2015 By @RhinoplastySyd

$nasal-fractures$

Nasal fractures are often the result of trauma to the face, such as from contact sports, vehicle accidents, fights and falls. Nasal fractures are one of the most common types of facial fracture, accounting for approximately 40% of facial fractures. It is not uncommon for other facial fractures or injuries to occur at the same time as the nasal fracture. Particularly in instances of trauma, it is also important to ensure that there is no injury to the cervical spine. Because the nose is such a prominent part of the face, it is vulnerable to injury.

Anatomy of the nose

The nose is comprised of both bony and cartilaginous parts. The superior (top) and posterior (rear) parts of the nose are the bony parts. The bones of the nose are the paired nasal bones, which make up the bridge of the nose. Parts of the maxilla, the bone that forms the top jaw, called the frontal processes also form part of the nose. The frontal processes attach to the lacrimal bone (which helps to form the tear duct) to form the lateral (side) part of the upper nose. In the midline of the nose, the rear part of the nasal septum is made of the perpendicular plate of the ethmoid bone. The floor of the nose is made up of the palatine bone and part of the maxilla, whereas the roof of the nose is formed by the cribriform plate of the ethmoid bone. The vomer is a tiny bone that helps to form the choanae, which are the openings at the back of the nose that lead into the pharynx (throat). On the wall of each nostril are 3 tiny bones; the superior, middle and inferior conchae. These are bony shelves which are involved in humidifying the air we breathe.

The inferior (bottom) part of the nose is mainly made up of several plates of cartilage. The anterior (front) part of the septum, the structure which internally divides the nose into two nostrils, is also cartilaginous. The cartilages are flexible structures and can resist impact better than the bony parts. The nasal bones are most likely to fracture. Although the cartilages do not fracture; they can be injured by trauma to the nose. For example, haematomas (collections of blood outside of the blood vessels) can form in the cartilage of the nasal septum.

Signs and Symptoms

$nasal-fractures-callus$

Usually, the most obvious sign of a nasal fracture is profuse bleeding from the nose (epistaxis). The nose has a rich blood supply and as a result, nasal fractures are frequently accompanied by bleeding from the nostrils. Nasal fractures can also cause pain, particularly across the bridge of the nose. As the structure of the nose is deformed by a fracture, patients find it difficult to breathe through their nose. The nose and face can become quite swollen and bruised. It is also common for someone with a broken nose to experience a black eye (or black eyes) a day or two after the fracture.

Management

Nasal fractures are treated differently according to the severity of the injury. Simple, well-aligned fractures of the nose may not require much more treatment than ice packs to alleviate pain and swelling, analgesia, rest and care not to further injure the nose. Severe, displaced fractures may require surgery. X-rays and CT scans are not always required to diagnose a broken nose, but may be required in the case of severe fractures or if other facial fractures are suspected.

If the fracture results in a poorly aligned nose, there are several options to reduce the fracture. If the misalignment is not too severe, the nose may be realigned without surgery. The nose can be reduced back into place and supported by packing inside the nostrils and a splint externally. However, if this is not achievable, surgical correction may be required. Surgery is particularly important if the fracture has altered the structure of the nose in a way that nasal breathing is obstructed, or if the fracture will not heal in the position it is in. Surgery is also important for cosmetic reasons. If surgery is not performed within 2 weeks of the injury, you may need to wait a few months for the swelling to subside so that the procedure can be performed.

If you have questions about nose surgery or are interested in rhinoplasty make an appointment to see our nose surgeon.

Protect Your Nose When Playing Rough Sports

November 15, 2014 By @RhinoplastySyd

Certain types of sports come with a rather significant risk of a broken nose. There are, however, ways that people can be smart and protect their noses from injury when playing such sports.

In cases where a nose is repeatedly or particularly badly fractured, rhinoplasty may be the best way of correcting any resulting issues. The issues can be serious, so it is important to be smart when engaging in contact sports and, in some cases, even sports that do not incorporate deliberate contact. This article provides general information about how to protect your nose when playing rough sports.

The Risk Elements

There are many types of sports that pose a significant risk of sustaining a broken nose. The most obvious are sports where contact between players is deliberate, such as rugby, boxing, MMA, wrestling and so forth. Other sports where there is a significant risk of a broken nose are those where a ball, puck or other object is used and where it may be flying at very high speeds. Even volleyballs with sufficient force behind them can fracture a nose, so it is important to be aware of the risks.

While these types of sports make pose a higher risk of a broken nose, remember that it is perfectly common for runners to trip, bicyclists to fall off their bikes and so forth, so there always is a risk of sustaining some damage while enjoying a bit of physical activity. Of course, the benefits of exercise far outweigh the risks and, even if your nose is fractured, it is likely that a cosmetic surgeon can fix it if the damage is severe and that it will heal fine on its own if the damage is not severe.

Protecting Your Face

Where bicycling, hockey and other sports where there is a significant risk of head injury are concerned, players generally wear helmets. They should always be worn if they are part of the usual uniform for the game. In sports where very hard contact is almost inevitable, helmets will generally be regulation equipment.

Even for boxers and martial artists, there is headgear available designed to protect the nose. This will generally leave adequate opening so that the athlete has their full range of peripheral vision, but it provides some padding and support to the structure of the nose in the very likely event that they take a blow straight to the face. This can go a long way toward preventing some of the most common injuries associated with fighting sports, such as broken teeth, broken jaws, broken noses and so forth.

In sports where people do not normally wear face guards, but where there is a risk of a broken nose, that risk may be something that the athlete has to accept. If your nose gets broken, however, rhinoplasty does provide a way of fixing the worst types of damage.

If Your Nose Is Broken

You need to visit a physician after you have a broken nose. Some potentially dangerous conditions may arise from a broken nose, even if it is not apparent that the damage is severe immediately.

Most of the time, with good emergency care, a broken nose will heal on its own and the worst of it will be the discomfort. If the septum, the portion of the nose that divides one nostril from the other, gets out of alignment, however, breathing trouble may result. Facial plastic surgeons can fix this, which fixes both the appearance and the breathing issues at the same time.

If you have a badly damaged nose from sports, remember to talk to a surgeon who performs rhinoplasty about the issue. Quite often, they can offer a solution that will alleviate cosmetic and breathing issues, sometimes with nothing more than an outpatient procedure.

If you have questions about broken nose or are interested in nose rhinoplasty make an appointment to see a rhinoplasty specialist.

References

The Benefits of Reconstruction Rhinoplasty

November 6, 2014 By @RhinoplastySyd

The earliest reports of reconstruction rhinoplasty date back to ancient India. Rhinoplasty techniques were carried out by the ayurvedic physician Sushruta (c. 800 BC), who described reconstruction of the nose in the Sushruta samhita (c. 500 BC), his medico–surgical compendium. The physician Sushruta and his medical students developed and applied plastic surgical techniques for reconstructing noses that were amputated as religious, criminal, or military punishment. Today, whilst many people choose rhinoplasty as a means of improving their appearance, rhinoplasty surgery can also have important functional benefits through addressing underlying problems with the nose.

When Reconstruction Is Needed

There are several reasons why a patient may need to consider reconstructive rhinoplasty. Some people may have obstructions within the nasal cavity that cause breathing difficulties. For such individuals, rhinoplasty surgery would focus on removing these obstructions to allow for easier breathing.

Another form of reconstructive rhinoplasty is referred to as revision rhinoplasty. This surgery addresses functional or aesthetic issues that have occurred from a previous rhinoplasty, i.e. a previous rhinoplasty did not have the desired result.

Reconstructive surgery may be required to fix any problems that result from a broken nose or other trauma, especially following accidents that damage the internal structure of the nasal passages.

Reconstruction rhinoplasty is also used to address problems related to cleft palate, cleft lip, or a combination of the two. In these cases, the rhinoplasty is not only used to try to provide a more natural appearance after cleft surgery, but it can also help rebuild the structures in the nose. Reconstruction rhinoplasty may be done in conjunction with cleft surgery in an effort to shorten the recovery periods that would be needed if the surgeries were done separately.

What to Expect with Reconstruction Rhinoplasty

Rhinoplasty surgery can be performed in either a closed or an open manner. If the surgeon opts for a closed surgery, this means that all incisions will be located inside the nose. Open rhinoplasty is performed by making an incision in the fleshy skin that is located in between the nostrils. Your surgeon will discuss these options with you to determine what will work best in your situation.

Reconstruction is very similar to normal rhinoplasty, but there are some situations where the surgeries differ. If revision is being used to address problems associated with a previous surgery, the process becomes much more complicated. In these instances, the surgeon must deal with a decrease in the amount of available cartilage, which often requires grafting from the rib or ear cartilage. This ensures that the surgeon has enough cartilage available to rebuild the structures of the nose.

Another issue that is common with revision rhinoplasty is the scar tissue that is present from previous surgeries. This results in a much more delicate process to try to prevent complications resulting from the bbuild-upof scar tissue after the surgery is completed.

The Outcome

Whilst there is no guarantee with any surgical procedure, reconstructive rhinoplasty generally has good results. Those who require the surgery for breathing issues are usually able to notice a difference soon after the surgery is completed and the swelling has subsided.

When reconstruction is used to address problems associated with trauma or cleft issues, surgical outcomes may vary depending on the severity of the initial issues. However, while these surgeries are performed to address problems of the inner structures, surgeons also focus on providing a pleasing appearance as well. A complete transformation may not be possible in all cases but there should be a marked improvement after the surgery is completed.

There are many functional benefits to reconstructive rhinoplasty, as well as aesthetic. Take the time to go over what you are hoping to accomplish with a qualified surgeon, and he or she will be able to help you understand the potential outcomes of your surgery.

If you have questions about reconstruction rhinoplasty contact your local doctor who will arrange for you to see a rhinoplasty specialist.

Reference

Revision Rhinoplasty

Broken Noses and Rhinoplasty

May 19, 2014 By admin

Broken noses are not uncommon. You can break your nose playing contact sports, getting in a fight, car accident, falling down, or just running into a door. Because your nose is mostly cartilage, the break itself will most often be over the bridge of the nose. So how do you know if you have a nasal fracture, or you’ve just been hit in the face hard enough to bruise your nose?

In extreme cases, you will be able to tell right away, as the nose will immediately look different, swollen and resting to one side or the other. Nasal fractures often come with heavy bruising under both eyes, swelling of the nose, and difficulty breathing. If you think you have broken your nose, you should go to the doctor immediately to set and treat it and to ensure that you do not have any other injuries. Concussions are common with trauma to the head and face, and you should have your doctor check you out thoroughly, just in case.

Surgery is not necessary for many nasal fractures. The nose is reset and bandaged. Then the patient spends the recovery time taking ibuprofen and feeling a bit silly for wearing a bandage on their face all the time. Once healed, however, despite being reset, your nose may still appear different than it did before.

You may have a notch on the bridge of your nose, or it may point slightly to one side or the other. Some people who’ve had multiple nasal fractures joke that, after being broken to one side, then the other, that, “My nose is more straight than it was when I was born!” This is not something to count on, though. If you are unhappy with the shape or angle of your nose after it has healed from a break, you may want to consider rhinoplasty.

Reshape your nose and breathe better

Rhinoplasty, commonly called a nose job, is a type of plastic surgery that can be done for purely aesthetic or for medical reasons. Many people associate rhinoplasty with Hollywood stars and their vanity, with completely reshaping the nose, but this is not always the case. If you’ve suffered from a broken nose, and you simply want to go back to the way you looked before, with a straight nose and no notch on the bridge, rhinoplasty can help you. This mild surgery could give you back the face you’ve grown accustomed to seeing in the mirror your entire life.

Another reason to consider rhinoplasty after a broken nose is potential breathing problems caused by the break. If, when your nose was broken, your septum is displaced, the doctor will often call for immediate nasal surgery to ensure that you can breathe properly. If, after your broken nose has healed, you have difficulty breathing, or you find you’re having snoring problems or issues with sleep apnea, you may need to consider rhinoplasty to correct these issues and breathe normally again.

Any injury that affects your nasal passages should be taken seriously. If you’ve broken your nose and gone to the emergency room to have it set, you should make a follow up appointment with your doctor. Your doctor can tell you whether or not you need to speak with a rhinoplasty specialist. If you’re all healed up, but you find it difficult to look in the mirror, you should also consult with at least one rhinoplasty surgeon. As is the case with most surgery consultations, a second opinion is always a good idea when looking at nasal reconstruction. Whether you choose to get nasal surgery for aesthetic or medical reasons, you want to make sure that you’ve made your best choice of doctor and procedure.

If you have questions about broken noses and rhinoplasty surgery, make an appointment to see our rhinoplasty specialist.