Broken nose

Your health care provider may press gently on the outside of your nose and its surrounding areas. He or she may look inside your nasal passage to check for obstruction and further signs of broken bones.

You may receive numbing medication to make your nose more comfortable during the exam.

X-rays and other imaging studies are usually unnecessary. However, a computerized tomography (CT) scan may be ordered if the severity of your injuries makes a thorough physical exam impossible or if your provider suspects you may have other injuries.

If you have a minor fracture that hasn't caused your nose to become crooked or otherwise misshapen, you may not need professional medical treatment. You may be fine just using ice on the area and taking over-the-counter pain medications.

Manual realignment

If the break has displaced the bones and cartilage in your nose, your health care provider may be able to manually realign them. This needs to be done within 14 days from when the fracture occurred, preferably sooner.

During this procedure, medication will numb your nose. In some cases, health care providers can push the nose back in place with their fingers. Sometimes, they may need to use special tools to help realign the broken bones and cartilage.

Your nose may be splinted with packing on the inside and a dressing on the outside. Sometimes, an internal splint is also necessary for a short time. If used, the packing usually needs to stay in for a week. The dressing may stay on for up to two weeks.

You may also be given a prescription for antibiotics to prevent infection from the bacteria that live in your nose.

Surgery

Severe breaks, multiple breaks or breaks that have gone untreated for more than 14 days may need surgery. Surgery can realign the bones and reshape your nose, if necessary.

If the break has damaged your nasal septum — the middle part of your nose that divides your nostril — your breathing may feel blocked or you may feel like you have a stuffy nose. Reconstructive surgery may be recommended.

If you think you may have broken your nose, take these steps to reduce pain and swelling:

• Act quickly. When the break first occurs, breathe through your mouth and lean forward to reduce the amount of blood that drains into your throat.
• Use ice. Apply ice packs or cold compresses immediately after the injury, and then at least four times a day for the first 24 to 48 hours to reduce swelling. Keep the ice or cold compress on for 10 to 15 minutes at a time. Wrap the ice in a washcloth to prevent frostbite. Try not to apply too much pressure, which can cause additional pain or damage to your nose.
• Relieve pain. Take over-the-counter pain relievers, such as acetaminophen (Tylenol, others), ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve, others), as necessary.
• Keep your head up. Elevate your head — especially when sleeping — so as not to worsen swelling and throbbing.
• Limit your activities. For the first two weeks after treatment, don't play any sports. Avoid contact sports for at least six weeks after your injury.

If your injury is severe, you won't have time to prepare for your appointment because you'll need to seek immediate medical attention.

If the injury to your nose is less severe — accompanied only by swelling and moderate pain — you may choose to wait before seeking care. This allows time for the swelling to subside, making it easier to evaluate your injury.

However, it's best not to wait longer than 3 to 5 days before seeing your health care provider if your signs and symptoms persist. During this waiting period, get medical attention if:

• The pain or swelling doesn't progressively improve
• Your nose looks misshapen or crooked after the swelling recedes
• You can't breathe well through your nose even after the swelling subsides
• You experience frequent, recurring nosebleeds
• You're running a fever

When you make an appointment, you may start by seeing your primary care provider. He or she may refer you to a specialist in disorders of the ear, nose and throat.

Here's some information to help you get ready for your appointment, and to know what to expect.

What you can do

• Write down any symptoms you're experiencing and what you were doing at the time of the injury.
• Make a list of all medications, vitamins, and supplements you're taking.
• Bring a photo of yourself before the injury for comparison, if possible.
• Write down questions to ask.

Preparing a list of questions can help you make the most of your time with your health care provider. For a broken nose, here are some basic questions to ask:

• Do I need any tests, such as X-rays?
• How long will the swelling and bruising last?
• Will my nose look the same?
• Do I need surgery?
• Do I need to restrict my activity?
• What type of pain medication can I take?
• Are there any brochures or other printed materials that I can take home? What websites do you recommend for additional information?

What to expect from your doctor

Your health care provider may ask:

• How and when did your injury occur?
• Have your symptoms improved at all since the time of the injury?
• Does your nose look the same or different to you?
• Can you easily breathe through your nose?
• Do you participate in contact sports? If so, how long do you plan on participating in this sport?