Dr. Wong Thoughts

Immediate Functional and Cosmetic Rhinoplasty following Nasal Injury/ Fracture: A New Thinking in the management of NOSE FRACTURES

posted May 29th, 2013 by waesthetics in THE NOSE and RHINOPLASTY

Nasal fracture is one of the commonest facial fractures associated with low or high velocity trauma to the face.

With fractures of the nose, it is generally recommended that a closed reduction and packing of the nose be done. While this approach is relatively simple and easy to do, the incidence of post reduction deformities may be as high as 50%! In other words, a significant number of patients treated with the closed reduction and splinting approach will end up having significant residual deformities as a result of the fracture and would require secondary corrective procedures to address these deformities. This is because the complexity of the fracture makes it difficult to relocate the fractured components into its exact anatomical position. Furthermore, the lack of ‘fixation’ and stabilization of the fractures will predispose to displacement of the fragments during the healing process.

Immediate open rhinoplasty following nasal fractures is a controversial topic. It is rarely done and not reported much in the medical literature.

I have been an advocate of immediate functional and cosmetic open rhinoplasty following nasal fractures for several years now. I have found that the open structural rhinoplasty, which is grounded in the principles that the nose must be structurally well supported as well as aesthetically pleasing, can safely, reliably and predictably be performed in the fractured nose in ASIAN patients.

Figure 1: Immediate Cosmetic and Functional Rhinoplasty following NASAL FRACTURE

A lot of my patients with nasal fractures also have certain aspects of their nose that they are unhappy with, usually a tip that is too big or not projecting enough, the base is too wide or the nasal bridge is too low. These aspects of the aesthetics of the nose can be improved during the rhinoplasty for the trauma.

With immediate functional and cosmetic open rhinoplasty following trauma, patients can expect to have a better functioning nose and better-looking nose after the surgery!

I have just published this experience with my mentor, the master rhinoplasty surgeon Dr Rollin Daniel of Newport Beach, CA, in the prestigious peer-reviewed journal, the Aesthetic Surgery Journal. Hope you enjoy reading the article available on our Website!

Dr Wong Chin Ho