A “dislocated nose” is the common term for a nasal fracture, which is a break in the bone or cartilage that forms the nose’s structure. Nasal fractures are the most frequent type of facial fracture, accounting for nearly half of all facial bone injuries due to the nose’s prominent position. This damage often involves the nasal bones and can also include displacement or fracture of the nasal septum, the wall that divides the nostrils.
Immediate Actions and Triage
The first steps following a nasal injury are to control bleeding and manage swelling. If the nose is actively bleeding, lean forward slightly and apply gentle pressure to the soft lower part of the nose for several minutes to encourage clotting. Maintaining an upright posture helps reduce blood pressure in the nasal veins, slowing the bleeding.
Applying a cold compress or ice pack to the bridge of the nose for 10 to 20 minutes at a time can limit swelling and pain. Patients should keep their head elevated, even while sleeping, for the first few days to aid in reducing fluid accumulation.
An immediate visit to an emergency room is necessary if there is uncontrolled bleeding, clear fluid draining from the nose, or an associated injury like loss of consciousness or double vision. A septal hematoma—a mass of blood under the lining of the septum—requires emergency drainage to prevent cartilage death and nasal collapse. Less severe injuries, primarily involving misalignment or difficulty breathing, can often be managed with an urgent appointment with an Ear, Nose, and Throat (ENT) specialist within the first week.
Why Attempting Self-Correction is Dangerous
The impulse to “fix” a visibly crooked nose at home is understandable, but attempting to self-correct a nasal fracture is dangerous and medically inadvisable. The bones and cartilage must be realigned precisely to ensure proper function and appearance. Without medical training, a person risks pushing the fractured segments into a worse position, which can cause permanent deformity or chronic breathing difficulty.
Applying force can cause further, more complex fractures to the damaged bone and cartilage. Improper manipulation can also damage the nasal lining, increasing the chance of infection. Furthermore, an untrained maneuver may cause or worsen a septal hematoma, a collection of blood that separates the cartilage from its blood supply. If not drained immediately, this can lead to cartilage death and a severe cosmetic and functional collapse known as a saddle nose deformity.
The Professional Reduction Procedure
The medical process to restore the nose to its pre-injury alignment is called a reduction. The timing of this procedure is important; it is generally delayed until three to seven days after the injury to allow severe swelling to subside. This delay permits the physician to accurately assess the damage before the fractured bones begin to set in an incorrect position, which typically happens after 10 to 14 days.
The two main types of reduction are closed and open, depending on the fracture’s complexity. A closed reduction is a non-surgical procedure used for simple, acute fractures where the nose is straightened without an external incision. The surgeon administers local or general anesthesia and then uses specialized instruments inserted into the nostrils to gently manipulate the displaced nasal bones and cartilage back into position.
Open reduction is a surgical procedure reserved for more severe, complex fractures, or those involving significant septal damage. This procedure involves making small incisions, often under general anesthesia, to directly visualize and reposition the fracture fragments and septum. The goal of both procedures is to restore the integrity of the framework for a satisfactory cosmetic outcome and proper nasal airflow.
Post-Treatment Care and Recovery
Following a nasal reduction, the patient will have an external plastic or metal splint placed over the bridge of the nose to maintain the new alignment. The surgeon may also place soft nasal packing inside the nostrils to support the septum and control residual bleeding. This internal packing is removed within one to seven days, and antibiotics are often prescribed to prevent infection while the packing is in place.
Bruising around the eyes, known as “raccoon eyes,” and swelling of the nose are expected and will take about two to three weeks to fully resolve. Patients should keep their head elevated and apply ice packs, avoiding direct pressure on the nose, for the first 72 hours to manage swelling. Pain is managed with over-the-counter medication, though stronger prescriptions may be given for the initial recovery period.
For the first four to six weeks, patients must strictly avoid activities that risk re-injury, such as contact sports or wearing heavy glasses. The external splint is removed during a follow-up appointment about a week after the procedure. The fractured bones require approximately six weeks to become solidly fused, and follow-up care ensures the nose is healing correctly.