Swollen, crooked or hard to breathe? When a broken nose needs surgery

A broken nose is one of the most common facial injuries, often caused by falls, car accidents, or sports-related trauma. While the sight of swelling, bruising, or a crooked nose can be alarming, not every nasal fracture requires surgery.

For many people, rest, ice, and time are enough for the nose to heal naturally. But in certain cases, surgery is necessary to restore proper breathing, correct the shape of the nose, and prevent long-term complications.

If you’ve recently injured your nose, Doctify makes it easy to connect with experienced ENT specialists who can assess your injury and guide you toward the right treatment.

What is a nasal fracture?

A nasal fracture is simply a break or crack in the bones of the nose. These injuries are especially common because the nose is the most prominent feature of the face.

Typical causes include contact sports, accidental falls, road traffic accidents, or any blunt trauma to the face.

Common symptoms include: pain, swelling, bruising around the eyes, a visibly crooked appearance, and difficulty breathing through one or both nostrils.

When is surgery needed?

Not every broken nose requires an operation — some mild fractures heal well on their own with conservative care. However, surgery is often advised in the following situations:

• Breathing difficulties: If swelling or bone displacement blocks the nasal passages, surgery may be necessary to restore airflow.
• Visible deformity: If the nose looks crooked, flattened, or misshapen after an injury, surgery can correct alignment and improve appearance.
• Severe or displaced fractures: When bones are significantly out of place, they won’t heal properly without intervention.
• Combined injuries: If the nasal septum (the wall dividing the nostrils) is damaged, surgery can both straighten the nose and improve breathing.

The key takeaway is that minor nasal injuries may only need simple first-aid measures — ice packs, rest, and pain relief. But if you can’t breathe properly or your nose looks deformed, an ENT surgeon should review you promptly.

Types of nasal surgery for fractures

There are several surgical approaches to repairing a broken nose, depending on the type and severity of the fracture:

Closed Reduction

This procedure is usually performed within 1–2 weeks of the injury, before the nasal bones begin to heal in the wrong position. Under anaesthetic, the surgeon gently realigns the bones without making major incisions. Closed reduction is quick, minimally invasive, and often restores both function and appearance effectively.

Open Reduction (Septorhinoplasty)

For more complex fractures — particularly those involving both the nasal bones and cartilage — open reduction may be required. This involves a rhinoplasty-style operation where the surgeon repositions bones, repairs cartilage, and sometimes reshapes the nose. In addition to restoring breathing, this approach can improve cosmetic appearance when the injury has caused significant changes.

Septoplasty

If the nasal septum (the central dividing wall) is bent or broken, it can block airflow and cause chronic breathing issues. Septoplasty straightens the septum and is often performed alongside fracture repair to optimise both function and alignment.

Risks and Considerations

As with all surgery, there are risks to consider. Temporary swelling, bruising, and nasal stuffiness are common in the first couple of weeks. Rare complications include bleeding, infection, scarring, or persistent deformity.

The best results are achieved when an ENT surgeon assesses and treats the fracture as soon as possible after injury — ideally within two weeks.

Recovery and Healing

Most nasal fracture surgeries are day procedures, meaning you can return home the same day. A small splint or cast is often placed on the nose for about a week to maintain alignment.

Swelling and bruising usually settle within one to two weeks, although it may take several months for the final shape of the nose to fully stabilise. Your surgeon will also advise when it is safe to return to sports, exercise, or other strenuous activities.

When to See a Specialist

You should seek medical advice if:

• Your nose looks crooked or misshapen after an injury.
• You are struggling to breathe through one or both nostrils.
• Swelling, bruising, or pain isn’t improving within a few days.

Early intervention offers the best chance of restoring both the function and appearance of the nose. Doctify helps patients book consultations with trusted ENT specialists experienced in nasal trauma care.

Conclusion

A broken nose doesn’t always need surgery, but if you’re left with breathing difficulties or a visibly crooked nose, surgical correction may be the right option. Closed reduction within two weeks of injury can often provide excellent results, while more complex cases may require reconstructive surgery.

The most important step is to seek early medical advice. With the right care, you can avoid long-term issues and recover both comfort and confidence.

Find the best ENT Surgeons in the United Kingdom or search for the best specialists globally:

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Medically Reviewed
Last reviewed on 04/10/2025